SAMDaily.us | PRESOL | Q | Cancer Registry/Certified Tumor Registrars Service

SAMDAILY.US - ISSUE OF NOVEMBER 23, 2019 SAM #6568
SOLICITATION NOTICE

Q -- Cancer Registry/Certified Tumor Registrars Service

Notice Date: 11/21/2019 2:32:39 PM
Notice Type: Combined Synopsis/Solicitation
NAICS: 541611 — Administrative Management and General Management Consulting Services
Contracting Office: 260-NETWORK CONTRACT OFFICE 20 (36C260) VANCOUVER WA 98662 USA
ZIP Code: 98662
Solicitation Number: 36C26020Q0036
Response Due: 12/10/2019 8:59:59 PM
Archive Date: 12/11/2019
Point of Contact: Craig Wagstaff
E-Mail Address: craig.wagstaff@va.gov
(craig.wagstaff@va.gov)
Small Business Set-Aside: SDVOSBS Service-Disabled Veteran-Owned Small Business (SDVOSB) Sole Source (FAR 19.14)
Awardee: null
Description: 1. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in FAR Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotes are being requested and a written solicitation will not be issued. A firm-fixed price purchase order is anticipated. FAR 13, Simplified Acquisition Procedures will be used.2. The solicitation number is 36C26020Q0036 and is issued as a Request for Quotes (RFQ). 3. The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular FAC 2005-89. The associated North American Industrial Classification System (NAICS) code for this procurement is 541611 with a small business size standard of 15 million dollars. This requirement is a SDVOSB set-aside and only qualified offerors may submit quotes. The Veteran s Health Administration (VISN 20) located in the Portland, Oregon area has a requirement for Cancer Registry Abstracting Services. See attached Solicitation4. PRICE SCHEDULE & LINE ITEMSITEM NUMBERDESCRIPTION OF SUPPLIES/SERVICESQUANTITYUNITUNIT PRICEAMOUNT00013,500.00EA____________________________________CASE FINDING - Electronically screen and accept all cases into the Cancer Registry DatabaseContract Period: BasePOP Begin: 01-01-2020POP End: 12-31-202000027,000.00EA____________________________________CASE ABSTRACTING AND CODING - Entering patient and disease specific information into the Veterans Administration VistA Cancer Registry DatabaseContract Period: BasePOP Begin: 01-01-2020POP End: 12-31-2020000310,000.00EA____________________________________FOLLOW-UP - shall complete data entry to include all required Commission on Cancer Registry fields, including but not limited to text, recurrence, treatment and required death information fields.Contract Period: BasePOP Begin: 01-01-2020POP End: 12-31-2020000450.00HR____________________________________CONSULT HOURS - shall provide Consult Hours if requested by the facility, that shall include time spent working with the Cancer Committee and the Cancer Program AdministratorContract Period: BasePOP Begin: 01-01-2020POP End: 12-31-2020000560.00EA____________________________________RAPID QUALITY REPORTING SYSTEM - shall monitor the quality of the Cancer Registry dataContract Period: BasePOP Begin: 01-01-2020POP End: 12-31-202010013,500.00EA____________________________________CASE FINDING - Electronically screen and accept all cases into the Cancer Registry DatabaseContract Period: Option 1POP Begin: 01-01-2021POP End: 12-31-202110027,000.00EA____________________________________CASE ABSTRACTING AND CODING - Entering patient and disease specific information into the Veterans Administration VistA Cancer Registry DatabaseContract Period: Option 1POP Begin: 01-01-2021POP End: 12-31-2021100310,000.00EA____________________________________FOLLOW-UP - shall complete data entry to include all required Commission on Cancer Registry fields, including but not limited to text, recurrence, treatment and required death information fields.Contract Period: Option 1POP Begin: 01-01-2021POP End: 12-31-2021100450.00HR____________________________________CONSULT HOURS - shall provide Consult Hours if requested by the facility, that shall include time spent working with the Cancer Committee and the Cancer Program AdministratorContract Period: Option 1POP Begin: 01-01-2021POP End: 12-31-2021100560.00EA____________________________________RAPID QUALITY REPORTING SYSTEM - shall monitor the quality of the Cancer Registry dataContract Period: Option 1POP Begin: 01-01-2021POP End: 12-31-202120013,500.00EA____________________________________CASE FINDING - Electronically screen and accept all cases into the Cancer Registry DatabaseContract Period: Option 2POP Begin: 01-01-2022POP End: 12-31-202220027,000.00EA____________________________________CASE ABSTRACTING AND CODING - Entering patient and disease specific information into the Veterans Administration VistA Cancer Registry DatabaseContract Period: Option 2POP Begin: 01-01-2022POP End: 12-31-2022200310,000.00EA____________________________________FOLLOW-UP - shall complete data entry to include all required Commission on Cancer Registry fields, including but not limited to text, recurrence, treatment and required death information fields.Contract Period: Option 3POP Begin: 01-01-2022POP End: 12-31-2022200450.00HR____________________________________CONSULT HOURS - shall provide Consult Hours if requested by the facility, that shall include time spent working with the Cancer Committee and the Cancer Program AdministratorContract Period: Option 2POP Begin: 01-01-2022POP End: 12-31-2022200560.00EA____________________________________RAPID QUALITY REPORTING SYSTEM - shall monitor the quality of the Cancer Registry dataContract Period: Option 2POP Begin: 01-01-2022POP End: 12-31-202230013,500.00EA____________________________________CASE FINDING - Electronically screen and accept all cases into the Cancer Registry DatabaseContract Period: Option 3POP Begin: 01-01-2023POP End: 12-31-202330027,000.00EA____________________________________CASE ABSTRACTING AND CODING - Entering patient and disease specific information into the Veterans Administration VistA Cancer Registry DatabaseContract Period: Option 3POP Begin: 01-01-2023POP End: 12-31-2023300310,000.00EA____________________________________FOLLOW-UP - shall complete data entry to include all required Commission on Cancer Registry fields, including but not limited to text, recurrence, treatment and required death information fields.Contract Period: Option 3POP Begin: 01-01-2023POP End: 12-31-2023300450.00HR____________________________________CONSULT HOURS - shall provide Consult Hours if requested by the facility, that shall include time spent working with the Cancer Committee and the Cancer Program AdministratorContract Period: Option 3POP Begin: 01-01-2023POP End: 12-31-2023300560.00EA____________________________________RAPID QUALITY REPORTING SYSTEM - shall monitor the quality of the Cancer Registry dataContract Period: Option 3POP Begin: 01-01-2023POP End: 12-31-202340013,500.00EA____________________________________CASE FINDING - Electronically screen and accept all cases into the Cancer Registry DatabaseContract Period: Option 4POP Begin: 01-01-2024POP End: 12-31-202440027,000.00EA____________________________________CASE ABSTRACTING AND CODING - Entering patient and disease specific information into the Veterans Administration VistA Cancer Registry DatabaseContract Period: Option 4POP Begin: 01-01-2024POP End: 12-31-2024400310,000.00EA____________________________________FOLLOW-UP - shall complete data entry to include all required Commission on Cancer Registry fields, including but not limited to text, recurrence, treatment and required death information fields.Contract Period: Option 4POP Begin: 01-01-2024POP End: 12-31-2024400450.00HR____________________________________CONSULT HOURS - shall provide Consult Hours if requested by the facility, that shall include time spent working with the Cancer Committee and the Cancer Program AdministratorContract Period: Option 4POP Begin: 01-01-2024POP End: 12-31-2024400560.00EA____________________________________RAPID QUALITY REPORTING SYSTEM - shall monitor the quality of the Cancer Registry dataContract Period: Option 4POP Begin: 01-01-2024POP End: 12-31-2024GRAND TOTAL__________________5. PERFORMANCE WORK STATEMENTThe Contractor shall provide all necessary labor, personnel, equipment, supplies, materials, supervision and other related services necessary to provide Cancer Registry services in accordance with VA and all applicable national standards. The goal of this procurement is to establish a safe and uniform process for maintaining an efficient & accurate cancer registry database in accordance with 100% of current Commission on Cancer (COC) standards, VHA cancer registry requirements, and State requirements (where applicable). This is a new requirement. Interested vendors must have at least three (3) years of experience in providing cancer registry services and recent experience with the COC standards. The contractor shall provide proof of adequate CTRs (Certified Tumor Registrar) in good standing per NCRA (National Cancer Registrar Association) to cover all the Cancer Registry services for each facility listed in item 1.1 above prior to being awarded the contract. All registry services under this contract must be performed by CTRs. Contractor must have a minimum of 12 CTR's at all times. �The contractor shall provide Cancer Registry Services for the following VA Medical Centers in Veterans Integrated Service Network 20 (VISN 20) facilities as follows and as applicable:Alaska VA Healthcare System and Regional Office (463)Boise VA Medical Center (531)Jonathan M. Wainwright Memorial VA Medical Center at Walla Walla (687)Mann-Grandstaff VA Medical Center at Spokane (668)VA Portland Healthcare System (648)VA Puget Sound Healthcare System (663)VA Roseburg Healthcare System (653)VA Southern Oregon Rehabilitation Center & Clinics at White City (692)All services will be performed as needed and in accordance with the Statement of Work and all contract clauses.6. STATEMENT OF WORKThe Contractor shall provide all necessary staffing and resources needed to properly maintain and provided VISN 20 VAMC s Cancer Registry database services in accordance with 100% of the current American College of Surgeons Commission on Cancer Registry standards and Veterans Health Administration (VHA) Cancer Registry requirements. VA reportable list will be shared with the receiving contractor after award. The Contractor shall have current experience managing a Cancer Registry program within the last two years and have recent experience with the American College of Surgeons (ACOS) Commission on Cancer (CoC) Standards. The duties and responsibilities of the Contractor shall include: Case Finding The Contractor shall electronically screen and accept all cases into the Cancer Registry database, and shall flag all cases as suspense with demographics and ensure cases are primary site coded. The Contractor shall be responsible for monthly review of disease indices, pathology reports, radiology reports, treatment logs, and other computerized methods to identify reportable cancer cases. The Contractor shall be responsible for transcribing and interpreting information from patient records regarding treatment of an estimated 11,400 new VISN 20 VAMCs cancer patients annually using the approved Veterans Administration (VA) abstracting software program (currently the VistA Oncotrax). The Contractor shall review all new cases for inclusion in the Oncotrax database in compliance with the industry standards of the North American Association of Central Cancer Registries (NAACCR), National Cancer Institute Surveillance, Epidemiology and End Results Program (SEER), World Health Organization International Classification of Diseases for Oncology (ICDC), American Joint Commission on Cancer (AJCC) Staging Manual Criteria, VA Central Cancer Registry (VACCR) Reportable List, American College of Surgeons/Commission on Cancer (ACOS/CoC) and the VISN 20 Cancer Registry criteria. The Contractor shall return a monthly list of cases accessioned along with the Contractor's monthly invoice to the COR and POC. Case Abstracting and Coding Abstracting is defined as coding and entering patient and disease specific information into the Veterans Administration VistA Cancer Registry database or other databases as identified within this statement of work, e.g. the Rapid Quality Reporting System (RQRS database). The Contractor shall provide complete, accurate quality abstraction services and shall ensure that all cases are cleared (within pre-established timeframes) in terms of passing edits required by the VA Central Cancer Registry or by the American College of Surgeons Commission on Cancer, e.g., National Cancer Database edits, Vista Oncology package edits, Gen-edits, Program edits, etc. The Contractor shall abstract oncology cases with 100% accuracy and shall ensure that all Commission on Cancer requirements/standards are met. Contractor is responsible to transcribe and interpret information form patient records regarding treatment provided to new cancer patients annually using the approved Veterans Administration (VA) abstracting software program (currently the VistA Oncotrax). The Contractor shall review and abstract the cancer patient s medical record on an ongoing basis in compliance with the industry standards of the North American Association of Central Cancer Registries (NAACCR), National Cancer Institute Surveillance, Epidemiology and End Results Program (SEER), World Health Organization International Classification of Diseases for Oncology (ICDC), American Joint Commission on Cancer (AJCC) Staging Manual Criteria, VA Central Cancer Registry (VACCR) Reportable List, American College of Surgeons/Commission on Cancer (ACOS/CoC) and the VISN 20 Cancer Registry criteria. The contractor will be a Certified Tumor Registrar (CTR), and produce and provide proof of current credential status, to provide abstracting services. The Contractor shall abstract cases within 4-6 months of the cancer diagnosis. The Contractor shall return a monthly list of case abstracts completed along with the Contractor's monthly invoice to the COR and POC. Follow-up- The Contractor shall complete data entry to include all required Commission on Cancer Registry fields, including but not limited to text, recurrence, treatment and required death information fields. The Contractor shall be responsible for tracking the care all patients receive in accordance with the current standard being-until the cancer survivor reaches the age of 100 years and following their cancer diagnosis at VISN 20 VAMCs and at all other health care institutions. The Contractor shall provide the Cancer Registry function of follow-up as described in the Standards of the American College of Surgeons/Commission on Cancer (ACOS/CoC), Facility Oncology Registry Data Standards (FORDS). These functions shall include computer input, data review and report generation tailored to the needs of the VA as described herein. The Contractor shall maintain follow-up at a minimum of 90% on all patients in the registry data base, this is required to use registry data for survival (outcome) analysis, which is industry standard. Cases are delinquent (lost) if the follow-up interval exceeds 15 months. The Contractor shall provide a monthly list of follow-up cases completed along with the Contractor s monthly invoice to the COR and POC.Consult Hours: The Contractor shall provide Consult Hours if requested by the facility, that shall include time spent working with the Cancer Committee and the Cancer Program Administrator. Consult hours shall also ensure all current ACOS and related Cancer Registry standards pertaining to the applicable VISN 20 VAMC Cancer Registry have been met such that all data entered the Cancer Registry is 100% accurate and all pre-established timeframes related to the Cancer Registry are met. Consult hours shall include producing reports, ensuring that the Cancer Registry Policy and Procedure Manual meets the Commission on Cancer Standards and is up to date, and assisting and advising all Cancer Program staff and related staff with Commission on Cancer survey readiness and preparation. Consult hours shall also include preparation of data for transmission to the State Tumor Registry and any other entity as required by the VA, such as the NCDB for American College of Surgeons. The contractor will provide consultative services both by telephone and on site to assist in the Commission on Cancer approval process. At this time, the VA Medical Centers in Alaska, Boise, Roseburg, Spokane and Walla Walla are not accredited by the ACoS. Should any VISN 20 VAMC facility that is not accredited with to pursue and obtain accreditation at present time or at any point in the future during the period of performance of this contract, the Contractor shall provide needed consultative services to ensure the applicable VISN 20 VAMC facility program meets accreditation program standards.Rapid Quality Reporting System: The Contractor shall monitor the quality of the Cancer Registry data. The Contractor shall monitor the facility's performance based on the CoC performance indicators, using the CoC reporting tools for the Rapid Quality Reporting System (RQRS) if requested by the facility, when facility does not have subject matter experts. The Contractor shall keep the Program Manager, the Cancer Liaison Physician, and the Chair of the Cancer Program Committee and the Cancer Program Coordinator advised of the performance status as requested by the above-mentioned staff, and no less than once monthly. (RQRS is a real-time data collection program to assess hospital-level performance using National Quality Forum (NQF) endorsed quality of cancer measures).Quality Assurance Surveillance Plan (QASP) The Contractor shall provide quality work, complete work, and accuracy as evidenced by meeting Commission on Cancer, National Cancer Data Base, National Cancer Registrars Association (NCRA) and VA Central Cancer Registry standards and requirements. The Contractor shall perform a 100% quality assurance review on all newly abstracted cases for compliance noting any deficiencies or non-deficiencies. The Contractor shall forward a list to the COR via e-mail monthly noting any deficiencies or non-deficiencies.The Contractor shall institute a Cancer Registry Quality Assurance Surveillance Plan/Program to evaluate the quality of 100% of their staff s Cancer Registry data and 100% of their staff s Cancer Registry activities done on behalf of the VISN 20 VAMCs. 7. AWARD EVALUATION & SELECTIONThe Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government. a. Basis for Award: Award will be made to the lowest price technically acceptable (LTPA) responsive and responsible Offeror. To receive consideration for award, a rating of acceptable must be achieved for the non-price factors to the quoted Cancer Registry Service. b. Factors to Be Evaluated: i. Factor A (Non-price factors)A-1: The contractor shall provide proof of adequate CTRs (Certified Tumor Registrar) in good standing per NCRA (National Cancer Registrar Association) to cover All the Cancer Registry services for EACH facility listed in item 1.5 of the Performance Work Statement A-2: Past Performance ii. Factor B (lowest technically acceptable price) B: Price c. Evaluation Approach: All proposals will be subject to evaluation by a technical evaluation team (TET) member familiar with the requirements of the solicitation. The Government intends to award without discussions based upon the initial evaluation of the proposals.All Offeror s are advised that, in the interest of efficiency, the Government reserves the right to conduct the evaluation in the most effective manner. Specifically, the Government will first evaluate the total proposed price of the base term and 4 (Four) one-year option periods. Thereafter, the Government will evaluate the non-price factors of the lowest quote for that item. If the lowest priced Offeror s proposal is determined to be rated as Acceptable, the Government may make award to that Offeror without further evaluation of the remaining proposals. If the lowest price proposal is determined to be rated Unacceptable, then the Government may evaluate the next lowest price proposal, and so forth and so on, until the Government reaches the lowest price proposal that is determined to be rated as Acceptable. However, the Government reserves the right to evaluate all proposals should it be desired to conduct discussions, or otherwise determined to be in the best interest of the Government.The proposals will be evaluated strictly in accordance with its written content. Proposals which merely restate the requirement, or state that the requirements will be met without providing supporting rationale are not sufficient. Offerors who fail to meet the minimum requirements of the solicitation will be rated Unacceptable and thus, ineligible for award.Non-price Factor Evaluation Approach: The evaluation process will consider the extent to which the proposal demonstrates a clear understanding of the non-price factors involved in meeting the solicitation requirements, and whether the Offeror has the corporate resources and ability to effectively manage the Statement of Work, and past performance record adequately and completely considered, defined and satisfied the requirements in the solicitation.A-1 The contractor shall provide proof of adequate CTRs (Certified Tumor Registrar) in good standing per NCRA (National Cancer Registrar Association) to cover ALL the Cancer Registry services for each facility listed in item 1.5 of the Performance Work Statement; Acceptable/Unacceptable Ratings (see note A.1.1) Rating DescriptionAcceptableThe Offeror s proposal shall demonstrate that they have corporate resources and ability to effectively manage the statement of work. Provide adequate proof of CTR in good standing.UnacceptableThe Offeror s proposal does not demonstrate that they have corporate resources and ability to effectively manage the statement of work. A-2. Past Performance Evaluation Rating Acceptable/Unacceptable Ratings (see note A.2.1)Rating DescriptionAcceptableOfferor s proposal must include three references, and based on the Offeror s past performance record, the Government has a reasonable expectation that the Offeror has the technical capability, by the size, scope, complexity, and results achieved in the completion of actual contracts/task orders similar to those expected under this order. UnacceptableOfferor s proposal must include three references, and based on the Offeror s past performance record, the Government has no reasonable expectation that the Offeror will have the technical capability, by the size, scope, complexity, and results achieved in the completion of actual contracts/task orders similar to those expected under this order.Note A1.1: Provide a proof of validate Certified Tumor Registrar (CTRs) in good standing per National Cancer Registrar Association (NCRA) to cover all the Cancer Registry services for each facility listed in Performance Work Statement, paragraph 1.5. Scanned copies are preferred.Note A2.1: Past Performance. Provide up to three (3) references for projects of similar size and scope performed for state or federal agencies of related projects that your company is currently engaged-in or has completed within the last 5 years. Include the following for each project reference:1. A brief description of the project2. Period of performance for the project3. A Point of Contact (POC) for the reference4. Contact information for the POC5. Identify if there was any instance in which your company could not completethe task or order and explain why?Price Evaluation Approach: The Government will evaluate offers by adding the total of all line item prices, including all options. The Total Evaluated Price will be that sum.Source Selection Decision: The three factors, pricing and two technical factors, shall be considered during the Government s evaluation of the submitted quotes. Once the item s quote has been determined to be acceptable, award will based on the lowest realistically priced, responsive, with satisfactory performance, and technically8. PROPOSAL SUBMISSIONThe Offeror s proposal should be submitted electronically by the date and time indicated in the solicitation. The Offeror s proposal shall consist of the non-price factors (technical and past performance) and price. The use of hyperlinks in the proposal is prohibited. (b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s). (c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.NOTE: An offeror s failure to provide the information specified in above in their quote shall result in being considered non-responsive and will not be considered by the government.Offerors should submit all questions regarding this solicitation to the Contracting Officer inwriting via email to craig.wagstaff@va.gov within 5 calendar days after issuance of thisRequest for Quote (RFQ). Questions received after the 5 calendar days will not be considered.Verbal questions will not be addressed. All responses to questions, which may affect offers, willbe incorporated into a written amendment to the solicitation.NOTE: Please note the email server has a size limitation of 5 GB. Zip files will be removedand therefore will not be considered. Late quotes will not be considered. The quote must bereceived by the due date/time as stated above. If you email your quote before the due date/time,but the government receives it after the due date/time, the quote is late and will not beconsidered.9. TIME DELIVERY & PLACE OF PERFORMANCEDelivery of Service and effective date will be 1/1/2020. All services will be reported to: Department of Veterans AffairsVeterans Integrated Service Network (VISN 20)1601 4TH Plain Boulevard, Building 17, 4th Floor, Suite 403Vancouver, WA 9866110. FAR CLAUSES & PROVISIONSThe full text of FAR provisions or clauses may be accessed electronically at http://acquisition.gov/comp/far/index.html. The following solicitation provisions apply to this acquisition:FAR 52.212-1, Instructions to Offerors Commercial Items (Oct 2018)FAR 52.212-3, Offerors Representations and Certifications Commercial Items (Oct 2018), applies to this acquisition and the following clauses and instructions are added as addenda:Offerors must complete annual representations and certifications electronically via the System for Award Management (SAM) website located at https://www.sam.gov/portal in accordance with FAR 52.212-3, Offerors Representations and Certifications Commercial Items. If paragraph (j) of the provision is applicable, a written submission is required.The following contract clauses apply to this acquisition: FAR 52.212-4, Contract Terms and Conditions Commercial Items (Oct 2018), applies to this acquisition and the following clauses and instructions are added as addenda:52.216-1 Type of Contract (Apr 1984)52-217-8 Option to Extend Services (Nov 1999)52.217-9 Option to Extend the Term of the Contract (Mar 2000)52.232-2 Service of Protest (Sep 2006)VAAR 852.211-72 Technical Industry Standards (Nov 2018)VAAR 852.219-10 VA Notice of Total Service-Disabled Veteran-Owned Small Business Set-Aside (Jul 2019)VAAR 852.219-74 Limitations o Subcontracting-Monitoring and Compliance (Jul 2018)VAAR 852.232-72 Technical Industry Standards (Nov 2018)VAAR 852.233-70 Protest Content/Alternative Dispute Resolution (Oct 2018)VAAR 852.233-71 Alternate Protest Procedure (Oct 2018)VAAR 852.273-74 Award without Exchanges (Jan 2003)FAR 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive Orders (Oct 2019), applies to this acquisition and the following clauses and instructions are added as addenda:11. PROPOSAL DUE DATE: Proposal must be emailed to craig.wagstaffva.gov and received no later than 1:00 pm Mountain Standard Time on 10 December 2019.
Web Link: SAM.gov Permalink
(https://beta.sam.gov/opp/9b35982e6fbe4b6e85f99582ab9cf6a7/view)
Place of Performance: Address: Department of Veterans Affairs;VISN 20;3710 SW US Veterans Hospital Road;Portland, OR 97239, USA; Zip Code: 97239; Country: USA
Record: SN05500517-F 20191123/191122081738 (samdaily.us)
Source: SAM.gov Link to This Notice
(may not be valid after Archive Date)

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Q -- Cancer Registry/Certified Tumor Registrars Service