Cancer Surveillance Change Management Timeline Assessment


The Mid-Level Tactical Group (MLTG) manages the cancer surveillance change control process assessing proposed additions, deletions, and revisions of data standards to ensure an efficient and timely change management process. MLTG is not a NAACCR committee, it is a collaborative body of the standard setting agencies. Members of MLTG include representation from:

  • American College of Surgeons Commission on Cancer (CoC) and the American Joint Committee on Cancer (AJCC)
  • Canadian Council of Cancer Registries (CCCR)
  • Centers for Disease Control and Prevention National Program of Cancer Registries (NPCR)
  • College of American Pathologists (CAP)
  • National Cancer Institute Surveillance, Epidemiology and End Results Program (SEER)
  • National Cancer Registrars Association (NCRA)
  • NAACCR Board of Directors
  • NAACCR Standardization and Registry Development Steering Committee

One of the MLTG tasks is to evaluate the change management process to ensure accordance and expediency. Last year NAACCR worked with an intern to assess the MLTG change management timeline for central cancer registries, cancer registry software vendors and hospital registries. Nine central cancer registries and four cancer registry software vendors were interviewed and over 200 hospital registrars completed a survey.

Central Registries

Central cancer registries were asked about their user-defined data dictionary and their registry-specific edits metafile. Most of the central cancer registries responded that it takes a week to create their user-defined data dictionary and 1-2 weeks to update their registry-specific edits metafile. However, central registries emphasized that implementation products (e.g., Data Dictionary, Edits Metafile, standard setter requirements, etc.) must be released timely for central registries to be able to complete their user-defined data dictionary and registry-specific edits metafile by October 1st. Many of the central registries mentioned that the October deadline for the user-defined data dictionary and registry-specific edits metafile conflicts with their work on the calls for data (CFD) from standard-setters. Some of the central cancer registries suggested moving the timeline from October to September for the user-defined data dictionary and the registry-specific edits metafile.

Hospital Registries

The hospital registrar survey asked when hospital registries would ideally like to start abstracting cases. Sixty-seven percent responded they would ideally like to begin abstracting in the first quarter of an implementation year. When asked about the ideal timing to upgrade their software, 74% responded they would like the software upgrade in the first quarter of the calendar year.

Software Vendors

Cancer registry software vendors were asked about the timing of the release of their software updates to the hospital registries. All four of the software vendors responded that they would ideally like to offer software updates from January to February. For software vendors to be able to provide the updates by January, the vendors would need the inputs from the central registries (user-defined data dictionary and registry-specific edits metafile) no later than October.


Based on the interviews and survey responses the ideal timeline diverges very little from the current MLTG timeline. The MLTG deadline for central cancer registries to submit their user-defined data dictionary and registry-specific edits metafile changed from October 1 to September 15. The deadline for hospital cancer registry software upgrades to be released will remain as January. NAACCR and the MLTG continue to work with registries and vendors to explore innovations and efficiencies to improve the timely availability of registry software updates.

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