The Criterion Newsletter from CCR


California Cancer Registry                                 March, 2011 - Vol 4, Issue 1

In This Issue

Update on Hinkley Cancer Incidence

How We Did It

Is That Your Final Answer?



Editorial Board

Katheryne Vance - Editor
Dennis O'Neal - Assistant Editor

Cathy Schindler - Editorial Assistant
The Criterion Advisors
Karen Homan - Region 1/8, CPIC
Crickett Dyke - Region 5, Desert Sierra CSP
Michelle King - Region 9, CSP
Dee LeTendre - CCR
Winny Roshala - CCR


Educational Opportunities 

April 13, 2011, NCRW Symposium Regional Meeting, CPIC, Oakland. Contact: Shawky Matta

April 14, 2011, 21st Annual CSP Educational Symposium, USC, Los Angeles. Contact: Donna Morrell at

April 19, 2011, Regional Registry Educational Program, LLUMC, Loma Linda. Contact: Becky Cassady at

May 15-18, 2011, NCRA 37th Educational Conference,Orlando, FL, Contact:

May 19-20, 2001, SEER Advanced Topics for Registry Professionals, Orlando, FL, Contact:

June 18-24, 2011, NAACCR Annual Conference, Louisville, Kentucky, Contact

June 22, 2011, Regional Meeting, CPIC, Oakland. Contact: Shawky Matta at


Quick Links

California Cancer Registry


California Department Public Health


Public Health Institute



TNM Manual Exchange!

Springer, the publisher of the AJCC 7th Cancer Staging Manual, is willing to replace any manual purchased from them before November 2010 for a new edition with errata corrected. Printings since November have the errors corrected.

Click here for details


Edits to 2009 CAP Cancer Protocols Now Available

In response to errata published by the American Joint Committee on Cancer (AJCC), the CAP released more than 50 updated Cancer Protocols, which are now available on the CAP website

  • No new required elements have been added to these protocols.
  • A summary of changes is listed in the Protocol Revision History section available on page three of every protocol.


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About This Issue

Katheryne Vance, BA, CTR

     There is a proverb that states: "No matter how long the winter, spring is sure to follow."  2010 data changes was a long laborious "winter" for the cancer registry profession. Our "spring" at the local and central level is evidenced by reviewing registry procedures for data changes, abstracting and submitting 2010 cases in CSv 02.02, listening to feedback, responding to questions, and soliciting clarifications when needed. Careful attentions to these details result in quality data.

     The news media has again cited Hinkley, California, as having higher than normal levels of hexavalent chromium (chromium 6) in groundwater. Dr.  John Morgan, epidemiologist, at the Desert Sierra Cancer Surveillance Program, describes an update to this recurring news in Preliminary Assessment of Cancer Occurrence in the Hinkley Census Tract, 1996-2008.
     The Editorial Board thought it would be of interest to add a viewpoint of 2010 data changes from the facility based cancer registry. The article How We Did It is an amalgam on how three facilities were able to maintain a high level of completeness through the data changes. The Editorial Board welcomes original articles from cancer registrars. If any reader would like to share a procedure, remedy, or an experience please contact me.
     The Commission on Cancer's new CAnswer system consists of a blog of question and answers. It can be challenging to decide the answer to any given question. The article Is That Your Final Answer? describes how to determine the final answer for the Collaborative Stage forums.
     An important part of Spring is National Cancer Registrars Week, April 11-15. The California Cancer Registry acknowledges all of your professionalism and dedication that proves Cancer Registrars Pave the Way to a Cure!


Update on Hinkley Cancer Incidence 

John W. Morgan, DrPH, CPH

Epidemiologist, Desert Sierra
Cancer Surveillance Program

     As part of the statewide cancer surveillance program of California, theDesert Sierra Cancer Surveillance Program (DSCSP) provides monitoring of cancer occurrence in Inyo, Mono, Riverside, and San Bernardino Counties, that currently include approximately four million residents. The DSCSP serves as part of the statewide California Cancer Registry (CCR), and has evaluated cancer occurrence in the Census Tract encompassing Hinkley, San Bernardino County, on two previous occasions. These results, which initially covered cases diagnosed from 1988-1993 were updated on September 25, 2000, to include findings for 1988-1998. No excess occurrence of all invasive cancers combined was found in either evaluation.
     Recent newspaper and media reports have described higher than normal levels of hexavalent chromium (chromium 6) in groundwater in the vicinity of Hinkley, California. These reports have raised concerns that the occurrence of cancer could be elevated in the population living in the area around Hinkley. In response to these concerns, the DSCSP conducted a third assessment of observed and expected counts of new invasive cancer cases in the Hinkley Census Tract for 1996-2008. Findings from this recent assessment serve as an update to previous reports.

Click here to continue this article.


How We Did It

Kim Etcheberry, RN, OCN
 Maia Bohm, CTR
 Elizabeth Los, BA, CTR 

     Imagine our surprise, and pleasure, when we received a compliment from Cynthia Creech, Data Collection Unit Chief, California Cancer Registry for being among the few facilities in our region to be at the expected level of completeness at this point in time. Sutter Auburn Faith was at 37% with Sutter Medical Center Sacramento inching up at 25% towards the expected goal of 42%. 2010 has presented every registrar in the state with very challenging circumstances, so Ms. Creech asked us to share "How we did it!" 

     We have maintained a close working relationship with our regional state registry unit. On their recommendation, we identified all 2010 cases diagnosed in 2009 and abstracted them early into the 2009 database prior to initiating the 2010 case accession. This enabled us to continue to abstract cases while waiting for the new version of CNExT to be released.

Click here to continue this article.


Is That Your Final Answer? 

Katheryne Vance, BA, CTR  

     The Commission on Cancer Inquiry and Response system was replaced with the CAnswer Forum with the implementation of CSv2. Until recently, unlike all other forums in the CAnswer Forum, users of the Collaborative Stage Forums could not reply to a thread or a response from the site specific Cancer Technical Advsiory Panel (CTAP).
     In order to ask for further clarification or to respond to a CTAP answer, users found it necessary to post another question. This was not a glitch in the system software, it was a purposeful design of the collaborative stage forum section.
     After receiving user feedback, the CTAP site specific teams and the CS Mapping Team have decided to open the Collaborative Stage forums to user postings. This will allow for better communication among registrars posting questions and CTAP team members responding to questions.

Click here to continue this article.


Chirps are observations, comments, and notations that are being passed along with the goal that registrars will apply these chirps to their abstracting styles. Think of these as friendly reminders or chirps.



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