CTR Data Quality Assurance & Cancer Program Standards 3 — Questions and Answers
Question 1: Which of the following best describes the purpose of a 'casefinding audit' in a hospital cancer registry?
- To verify that staging codes are accurate
- To confirm all reportable cancer cases are being identified and entered (Correct answer)
- To evaluate the timeliness of case submission
- To assess the quality of treatment data
Correct answer: To confirm all reportable cancer cases are being identified and entered
A casefinding audit verifies that the registry's case identification process captures all reportable malignancies seen at the facility.
Question 2: When auditing the 'diagnostic confirmation' data field, which code is assigned to a case confirmed by cytology only, without histologic tissue?
- Code 1
- Code 2
- Code 4 (Correct answer)
- Code 6
Correct answer: Code 4
NAACCR/SEER code 4 is used when diagnostic confirmation is by cytology only, without a histologic (biopsy) confirmation.
Question 3: A program receives its NCDB benchmark report showing that its lymph node examination rate for colon cancer is significantly below the national rate. The BEST next step is to:
- Ignore the benchmark as it reflects national data, not local practice
- Present findings to the Cancer Committee and initiate a clinical study (Correct answer)
- Recode the cases to improve the rate
- Submit a variance report to the CoC
Correct answer: Present findings to the Cancer Committee and initiate a clinical study
Benchmark discrepancies should be presented to the Cancer Committee, which may initiate a clinical study to investigate and improve clinical practice.
Question 4: Which NAACCR data item captures the extent of disease at the time of initial diagnosis and is required for central registry submissions?
- Collaborative Stage
- TNM Pathologic Stage Group
- Summary Stage (Correct answer)
- SEER Combined Summary Stage
Correct answer: Summary Stage
NAACCR Summary Stage (derived from SEER Summary Staging) is a required data item for central registry submissions representing extent of disease at diagnosis.
Question 5: The 'Class of Case' field in a cancer registry distinguishes between:
- Primary and metastatic tumors
- Analytic and non-analytic cases (Correct answer)
- Benign and malignant histologies
- Invasive and in-situ cancers
Correct answer: Analytic and non-analytic cases
Class of Case separates analytic cases (diagnosed and/or treated at the facility) from non-analytic cases (treated elsewhere, diagnosis only confirmed here).
Question 6: A hospital registry's re-abstraction audit reveals that treatment data accuracy for radiation therapy is only 78%. Which action would MOST directly address this deficiency?
- Increase casefinding frequency
- Conduct targeted training on radiation therapy documentation sources (Correct answer)
- Expand the casefinding sources list
- Submit a corrected file to the state registry
Correct answer: Conduct targeted training on radiation therapy documentation sources
Targeted training on the relevant documentation sources (radiation oncology records, treatment summaries) directly addresses abstractor knowledge gaps in that specific data element.
Question 7: Under STORE (Standards for Oncology Registry Entry), what is the rule for coding a synchronous primary when both tumors arise in paired organs?
- Report only the higher-stage tumor
- Each tumor is reported as a separate primary with its own accession number (Correct answer)
- Combine into one record with bilateral site code
- Report only if histologies differ
Correct answer: Each tumor is reported as a separate primary with its own accession number
STORE rules require that synchronous primaries in paired organs be reported as separate primaries, each with its own accession number.
CTR Data Quality Assurance & Cancer Program Standards 3
Which of the following best describes the purpose of a 'casefinding audit' in a hospital cancer registry?