• Data Submission Form
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Data Submission Form

    Submission Form

1. Please select Data submission type.
   • 24–Month data
   • 12–Month Data
   • Both (24 month and 12 month data)
2. Click 'Next' button and navigate to 'NPCR–CSS Submission Form'.
   Input the 'Name' as Primary contact for data submission and 'Phone Number' with (xxx)xxx–xxxx format.
   Choose the configuration file used for extracting NPCR submission data in the drop–down menu.
   Input the number of cases submitted for each diagnosis year.
3. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – Death Clearance Conducted'.
   Choose 'Yes or No' for 'Death Clearance Conducted' for each 'Diagnosis Year' or
   Choose 'Yes or No' for 'All years for 24 months' to select all diagnosis years together.
4. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – IHS Linkage'.
   Choose 'Yes or No or Not Applicable' for 'IHS Linkage' for each 'Diagnosis Year' or
   Choose 'Yes or No or Not Applicable' for 'All years for 24 months' to select all diagnosis years together.
5. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – VHA Data Source '.
   Choose 'Yes or No or Partial or NA' for 'Are the VHA facilities in your state submitting data to the CCR' and 'Is VHA data included in your submission file' for each 'Diagnosis Year' or
   Choose 'Yes or No or Partial or NA' for 'Are the VHA facilities in your state submitting data to the CCR' and 'Is VHA data included in your submission file' for 'All years for 24 months' to select all diagnosis years together.
6. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – NPCR–EPHTN Sub–County Data Presentation'.
   Choose 'Yes or No' for 'Please indicate if data for NPCR–EPHTN Sub–county are to be supressed above and beyond the supression rules described above. This agreementment will remain in place until a new agreement is signed'.
   Choose 'Yes or No' for 'Please indicate if data may be included and displayed for the Tracking SIR project. This agreementment will remain in place until a new agreement is signed'.
   Select the agreement period for the SIR project either '3–year and 5–year periods or 5–years only'.
7. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – NHAPIIA Run and NHIA Exclusion'.
   
   • NHAPIIA Run
     Using NAACCR*Prep, derive and record the NAACCR Hispanic Identification Algorithm (NHIA) Derived Hispanic Origin [#191] and NAACCR Asian/Pacific Islander Identification Algorithm (Race—NAPIIA) [#193]. For details, refer to the Submission Specification.
   • NHIA Exclusion
     In running the NHIA algorithm, we strongly recommend that registries choose option 1, which limits the Spanish surname portion of the algorithm to cases coded as surname only (item 190=7) or unknown whether Hispanic (item 190=9) in counties that are less than 5% Hispanic. Enter "No Exclusion", "Option 1", "Option 2" or "Other".
     Definitions:
     No Exclusions were Applied(this is the default in the SAS program).
     Option 1: In counties in which less than 5% of the population is of Hispanic ethnicity, the surname portion of the algorithm was only applied to cases coded as "Spanish surname only" or "Unknown whether Spanish or not" (item 190 – codes 7 or 9).
     Option 2: In counties in which less than 5% of population is of Hispanic ethnicity, the surname portion of the algorithm was only applied to cases coded as "Spanish surname only" (item 190 – code 7). All cases coded to "Unknown whether Spanish or not" (item 190 – code 9) were converted to non–Hispanic in NHIA.
     Or Other, please specify in the form
8. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – Data Item Not Transmitted'.
   • Select (Click) 'All Data Items Transmitted' to delete the selected items in the 'Data Items Not Transmitted' table list
   • Deselect 'All Data Items Transmitted' to select the data item(s) from the 'Data Items Not Transmitted' table list. Multiple data items may be selected by checking the checkbox as you make your selections and press "Add" button. Provide an explanation in "Comments" for each added data item.
9. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – Duplicate Protocol'.
   'NAACCR Protocol for the Identification of Duplicate Cases'.
   Record the total number of records randomly selected and reviewed for each diagnosis year period.
   Record the total number of duplicate records identified in the Duplicate Assessment Protocol for each diagnosis year period.
   Record the NPCR National Data Quality duplicate protocol results (rate/1,000 records) for each diagnosis year period.
   
10. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – Data Item Quality and Consolidation'.
    Prior to executing the NPCR–CSS Submission Edits, choose 'Yes or No or Partial or Not Applicable' for each of the data items that were 'Edited, Evaluated, and Consolidated' in each category, or
    Choose 'Yes or No or Partial or Not Applicable' for 'Edited, Evaluated, and Consolidated' to select all data items in every category. Perform this selection for 24–month and 12–month data in the provided tables.
11. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – Follow–up Source'.
    Choose 'Linkages Performed or Linkages Not Performed' for 'Linkages Performed' for each Diagnosis Year or
    Choose 'Linkages Performed or Linkages Not Performed' for 'Linkages Performed' for all 24–month Diagnosis Years together.
    Choose 'Linkages Performed or Linkages Not Performed' for 'Linkages Performed' for the 12–month Diagnosis Year.
    
    • Choose 'Selected Site(s)', the 'Select site(s) from the listed' will be enabled to select.
    • Choose 'All Sites', the all 'Select site(s) will be included.
12. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – Follow–up Source'.
    Choose 'All Sites or Selected Sites or Not Done' for 'Conducted active follow up to determine vital status' for each Diagnosis Year or
    Choose 'All Sites or Selected Sites or Not Done' for 'Conducted active follow up to determine vital status' for all 24–month Diagnosis Years together.
    Choose 'All Sites or Selected Sites or Not Done' for 'Conducted active follow up to determine vital status' for the 12–month Diagnosis Year.
    
    • Choose 'Selected Site(s)', the 'Select site(s) from the listed' will be enabled to select.
    • Choose 'All Sites', the all 'Select site(s) will be included.
13. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – Follow–up Source'.
    Choose 'All Sites or Selected Sites or Not Done' for 'Linked with state vital statistics records to update vital status, including date and cause of death for each Diagnosis Year or
    Choose 'All Sites or Selected Sites or Not Done' for 'Linked with state vital statistics records to update vital status, including date and cause of death for all 24–month Diagnosis Years together.
    Choose 'All Sites or Selected Sites or Not Done' for 'Linked with state vital statistics records to update vital status, including date and cause of death for the 12–month Diagnosis Year.
    
    • Choose 'Selected Site(s)', the 'Select site(s) from the listed' will be enabled to select.
    • Choose 'All Sites', the all 'Select site(s) will be included.
    Choose 'All death years or Selected death years' for 'Death Years Searched'.
    
14. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – National Death Index (NDI) Questions'.
    Choose 'Yes or No' for 'Linked with NDI during the current calendar year to update vital status, including date and cause of death?' If Yes, upload NDI Fee Worksheet using the 'Select' button.
    Choose 'Yes or No' for 'Linked with NDI during the current calendar year to update vital status, including date of death?' If Yes, upload NDI Fee Worksheet using the 'Select' button.
    Choose 'Yes or No' for 'Linked with Social Security Death Master File (SSDMF) during the current calendar year?'
    
15. Click 'Next' button and navigate to 'NPCR–CSS Submission Form – Follow–up Source'. Select options to indicate if submission data were linked with other sources to update vital status, including date and cause of death.
    Has same functionality as step 12.
16. Click 'Next' button and navigate to the review page of 'NPCR–CSS Data Submission Form'.
    Modify each section by clicking the corresponding button.
17. Click 'Submit' button and navigate to 'Confirmation page' and to download the data submission form.
    Click the Back Arrow to navigate to the 'Login' page.

    Submission Form Review

Click the 'Save and Review' link on the top right corner of each submission form and navigate to the review page, this page allows review and modification.

    Re-submit Data Submission Form       

From the 'Save and Review' link on the top right corner of each submission form, navigate to the review page and click 'Back to Introduction Page' and start to re–submit.

Print Blank Submission Form

     Click 'Print Blank Submission Form' link on the Introduction Page to print the blank submission form.

Download Adobe Reader

    Click 'Download Adobe Reader' link to download the Adobe Reader to view Portable Document Format (PDF) files.

Logout

• Click 'Save & Logout' link on the top right corner of each submission form to save form and navigate to Login page.
• Click 'Logout' button on the right top of each submission form to logout without saving changes.