Proposal to revise ONS control file to reduce the number of requests for bypass

Background

Following a request for amendment to the Office for National Statistics (ONS) control file made at the Coding and Classification Working Group (CCG) on 19 January a review of the control file was proposed. This was accepted by the Cancer Registration Subgroup (CRS) on 1 February 2007.

The ONS control file is a set of validation rules that is used to check electronic submissions of cancer registration data for inconsistencies. Records that fail one or more validation checks are returned to the registry of origin for resolution. If the registry confirms the record as accurate, a bypass request is submitted so that the record can be accepted onto the ONS cancer system, by-passing the validation rule. Many registries anticipate records failing the control file checks and submit a request for bypass with the initial record so that further checking is not necessary.

ONS produced a summary of all requests for bypass made to ONS in a calendar year (See appendix 1) by type of requests sent by the cancer registries. At the CCG meeting on 20 April frequent bypass requests were considered to determine if a change in the control file would reduce the number of requests whilst still maintaining data quality. Some of the requests seemed to warrant a change in registry practices. These are presented in this document as recommendations, subject to ratification by the CRS.

Recommendations (Number of requests to ONS)

a) Malignant Melanoma (MM) (24 requests)
MM (8720/3)) is found in almost all hollow organs of the body. The group agreed that the control file should accept all sites. The only exceptions would be Brain (C71), Liver (C22) and Kidney (C64).

Change: Permit 8720/3 for all sites C00 -76 Except C22, C64, and C71.

b) Non-small cell carcinoma of sites other than the bronchus (9 requests)
Code (8046/3) is an ICD-O3 code that was implemented in ONS only for use in bronchus (C34). Carcinoma NOS (8010/3) should be used in preference for all other sites.

Change: Restrict 8046/3 to C34

c) Gastrointestinal stromal tumours (GIST) (26 requests)
Malignant Mesenchymoma (8990) is nearest morphology code in ICD-O2 for GIST. It can occur anywhere in the GI tract and the control file should permit site codes C17-C21 with 8990/3.

Some cases are of uncertain behaviour (code 1) so D37.1 - D39.9 are acceptable with 8990/1.

Change: Permit 8990/3 with C17-21,

Permit 8990/1 with D37.1 – D39.9

d) Site codes with metastatic tumours (91 requests)
ICD10 codes C00-76 should only be submitted with Behaviour codes 3 or 5. If the primary is known then distant metastases are recorded in the metastases field. Metastatic cases with unknown primary (behaviour code 6) must have a site code in the range C77-C80.

NB: In ICD-O2 there are two morphology codes which have a preferred behaviour code 6 and a recommended site code in the range C00-C77. The CCG suggests the following site codes in preference. For pseudomyxoma peritonea (8480/6) use secondary malignant neoplasm of retroperitoneum and peritoneum (C78.6), and for metastatic signet ring cell carcinoma (Krukenberg’s tumour) (8490/6) use secondary malignant neoplasm of ovary (C79.6).

Change: Behaviour code 6 can only be linked to C77-C80. Behaviour code 6 is not valid for site codes C00-C76.

e) Serous adenocarcinoma and cystadenocarcinoma (66 requests)

The control file was considered to be too restrictive for these tumours of the peritoneum, endometrium, ovary, uterus and cervix.

Change: For site codes C54.1, C48, C56, C53.0 the CCG recommend the following morphologies should be permitted;

Ovary (C56*)

Peritoneum (C48*)

Cervix (C53*), Uterus (C54*, C55)

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f) Chondrosarcoma of the larynx (1 request)
The control file should be changed to allow chondrosaroma (9220/3) only cartilage of larynx (C32.3). Larynx (C32.0) is not acceptable.

Change: Preclude 9220/3 with C32.0

g) Microcarcinoma of Thyroid (5 requests)
The CCG recommendation (reference from minutes) to use the ICD-O3 code 8341/3 for this condition has not been updated in the control file.

Change: Permit 8341/3 with C73.*

h) Germinoma (90643) (7 requests)
These tumours can occur in any of the midline organs.

Change: the following sites are valid with 9064/3

No other sites should be accepted

Implementation

The principle of changing the control file to reduce bypass requests was accepted at the CRS meeting on 15 May 2007. This revised proposal is now for consideration by the group until 19 June. Any changes should be consistent with the library of recommendations. Once accepted the changes will be made to the change control file by 31 July 2007.