The SC General Assembly passed the Central Cancer Registry Act, SC Law 44-35 on June 6, 1996. The Central Cancer Registry Act supports the assurances of Public Law 102-515 and states that all health care providers must report cancer cases to the SCCCR. The Act also ensures that patient confidentiality, as well as physician confidentiality, is protected. Reporting sources who submit data to the SCCCR are also protected from liability incurred through compliance with the state law.
Guidelines for reporting cancer to the South Carolina Central Cancer Registry (SCCCR) are established by the North American Association of Central Cancer Registries (NAACCR).
Electronic reporting is the automated generation and transmission of case reports from the electronic health record (EHR) to public health agencies for review and action.
Value of Electronic Case Reporting (eCR)
- More complete, accurate data in real time for action
- Diminishes burden on healthcare provider to report
- Drive the standardization of cancer reporting
- Increase the efficiency and timeliness of reporting
Electronic reporting goal: Sustainable approach to using health care’s EHR data to improve public health surveillance.
Reporting By Pathologists
Research outcomes and future advancements in cancer treatment depend on the quality of the data provided to cancer registries. As a pathologist, the information you provide to SCCCR is of critical importance because it raises the level of diagnostic accuracy. Your participation in reporting ensures the data received by SCCCR is highly reliable and accurate.
Electronic reporting can further drive the standardization of cancer reporting and can also increase the efficiency and timeliness of reporting. In accordance with South Carolina SECTION 44 35 5, all pathologists will be required to report cancer diagnoses electronically.
When and What to Report
All reportable neoplasms meeting the criteria as outlined in the SCCCR Data Reporting Manual should be transmitted to SCCCR. Neoplasms outlined under Non-Reportable Diagnoses do not need to be transmitted. In the event an ambiguous term(s) precede a reportable cancer diagnoses, the case is to be considered reportable. Examples of ambiguous terminology include, but are not limited to the following: apparently, appear to, suspicious, likely or most likely, favors, comparable, consistent with, typical (of), probable, presumed, malignant appearing.
• Invasive malignancies
• In situ malignancies
• Benign and borderline intracranial and/or central nervous system (CNS) tumors
• All hematopoietic and lymphoid neoplasms as outlined by SEER are reportable
• Carcinoid tumors, NOS of the appendix
• Severe or high-grade dysplasia, documented as being synonymous with carcinoma
• Neuroendocrine tumor when the diagnosis is insulinoma
• Cystic pancreatic endocrine neoplasm (CPEN)
• Cystic pancreatic endocrine specified as neourendorcrine tumor, grades 1 and 2
• Solid pseudopapillary neoplasm of pancreas
• Non-invasive mucinous cystic neoplasm (MCN) of pancreas with high-grade dysplasia
• Mature teratoma of the testes in adults
Pathology Report Types
The following types of pathology reports that provide information on reportable neoplasms should be transmitted to SCCCR:
- Surgical pathology reports: Biopsy (needle core, excisional, incisional, bone marrow aspirates), surgical resection, surgical re-excision
- Cytology reports:
• Biopsy (fine-needle aspiration)
• Brushings (e.g., endoscopic evaluation of pancreas, PAP smear)
• Fluids (urine, peritoneal, pleural, cerebrospinal)
• Fluid, broncheoalveolar lavage
• Hematologic-specific reports
• Immunohistochemistry (IHC)
• Peripheral blood count flow cytometry
• Molecular reports, including: molecular diagnosis PCR, RT-PCR, sequencing (NGS, pyrosequencing, etc.), ISH, FISH, gene array
- Slide reviews
- Biomarker results
- Pathology report addenda
Required Data Elements
All data elements listed in the CCR NAACCR Volume 5 Version 4.0 – HL7 2.5.1 Constraints Document (revised 02-10-2019) are required if accessible. These data elements include:
• Facilities information
• Ordering provider information
• Patient demographics
• Tumor-specific information
Facilities and ordering provider information is required in order to successfully match pathology information to existing records in SCCCR’s database and/or to match to the criteria for research studies and clinical trials. Patient demographic items are essential for epidemiological incidence and mortality research.
CCR recognizes that not all facility and patient information may be available to all pathologists. However, it is likely that facility/office electronic health record (EHR) systems will contain many of these data elements, so SCCCR recommends that laboratory information system (LIS) vendors work with ordering facilities/offices and their EHR vendors to enable these kinds of data elements to be transmitted to SCCCR.
Guidance on Reporting
Pathology Laboratory Electronic Reporting (NAACCR Volume V Version 4.0)
Method of Transport: Pathology Laboratories should use the Public Health Information Network-Messaging System (PHINMS) to securely transmit electronic pathology reports to the South Carolina Central Cancer Registry.
PHINMS: Please contact the South Carolina Central Cancer Registry(SCCCR) using the following e-mail address: firstname.lastname@example.org with any questions related to using PHINMS as the method of transport.
The majority of new cancer cases reported to SCCCR each year (~80%) are reported by hospitals. Cancer registrars have a vital role in ensuring that hospitals and facilities report cancer cases in an accurate and timely manner.
How to Report
The SCCCR uses an application called Web Plus for all entities to report their data. The following information and instructions to use this application are listed below.
The preferred web browser to use this application is Google Chrome.
Web Plus Link: https://apps.dhec.sc.gov/Health/WebPlus/logonen.aspx
If you do not have a Web Plus account please send an e-mail to email@example.com and an account will be created for you.
If you are uploading data in a NAACCR V18 format please use the following instructions.
Web Plus uploading instructions for NAACCR
If you are uploading other formats such as spreadsheets, documents, pdf, etc. please use the following instructions.
Web Plus uploading instructions for Non-NAACCR
Reporting by Physicians
As a physician, you provide valuable information to the SCCCR. You are responsible for managing your patient’s diagnostic and treatment information, and are also often the first to inform patients of their diagnosis and treatment options.
This section contains guidance on SCCCR reporting requirements for physicians, including information about which types of cancers must be reported, how, and where to report cancer information.
When and What to Report
In 1995, the South Carolina legislature enacted a law that established the South Carolina Central Cancer Registry (SCCCR) and since 1996, establishes rules implementing Sections 44-35-20 through -40, 1976 S.C. Code of Laws and Supplement has required hospitals, physicians, and certain other healthcare providers to report all new diagnoses of cancer. Beginning January 1, 2001, diagnoses of benign and borderline primary intracranial and central nervous system (CNS) neoplasms as well as Reportable Hematopoietic Diseases are reportable. Physicians1 must report diagnoses for patients who do not undergo diagnostic procedures or treatment of their malignancies or brain neoplasms at a hospital or other cancer-reporting facility2 in South Carolina. Confidentiality of data collected is strictly maintained in accordance with Health and Safety Code SECTION 44 35 40. Confidentiality; data release protocol; and Federal Law PL 104-191.
Physicians should report cancer diagnosis within 30 days of first seeing the patient for cancer. SCCCR has adopted the morphology section of the International Classification of Diseases for Oncology which delineates the list of reportable neoplasms.
Reporting is required for all diagnoses that meet the following criteria:
• Invasive and in situ malignancies including leukemia and lymphoma
• Benign and borderline primary intracranial and CNS neoplasms where reportable starting January 1, 2001
• All hematopotietic and lymphoid neoplasms as outlined by SEER are reportable
The following cases are exempt from reporting:
• Basal or squamous cell carcinoma of the skin, unless it occurs on the genitalia
• Carcinoma in situ or intraepithelial neoplasia grade III (CIN III) of the cervix diagnosed January 1, 1996 and later
• Benign and borderline neoplasms are not reportable unless they are primary intracranial and/or CNS neoplasms
General Instructions for Reporting
Physicians are responsible for reporting the following types of cases:
• A diagnosis must be reported even if it has not been microscopically confirmed
• Patient was not previously admitted as an inpatient or outpatient to a South Carolina cancer-reporting facility for this tumor
• Patient is not being referred to a hospital or other cancer-reporting facility for diagnosis or treatment for this tumor
• If patient is referred to a cancer-reporting facility for a condition other than this tumor, the case must be reported by the physician
Information Required and Guidance on Reporting
To maintain high standards in reporting accuracy, please reference the SCCCR Reporting Source Manual for a complete guide for reporting by physicians.
How to Report
Reference link to registration portal, if already registered, direct physicians to the appropriate section either MU/MIPS/Promoting Interoperability reporting or other options.
MU/MIPS/Promoting Interoperability Reporting
To participate in MU2 for cancer reporting for this criteria Physician Offices must meet the HL7 Clincal Document Architecture (CDA) 2.0 standard, and messages must conform to the CDA implementation specifications found in the Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries. In addition, the technology used by the Physician Office to generate the HL7 CDA XML message has to be a Federally Certified 2014 Edition EHR technology.
Meaningful Use Stage 3
The South Carolina Central Cancer Registry had declared its readiness to meet the Stage 3 Meaningful Use Cancer Measure for Stage 3 Meaningful Use in 2017. Physician Offices must conform to the HL7 CDA Release 2 Implementation Guide: Reporting to Public Health Cancer Registries from Ambulatory Healthcare Providers, Release 1, DSTU Release 1.1 – US Realm (Use hyperlink to the CDC web site for this guide). In addition, the technology used by the Physician Office to generate the HL7 CDA XML message has to be a Federally Certified 2015 Edition EHR technology.
For additional information or questions about Cancer Registry reporting, you may contact: CancerRegistryMU@dhec.sc.gov or call (803) 898-8000.