Cancer Reporting: Facility Resources

Standards for Reporting

Guidelines for reporting cancer to the Tennessee Cancer Registry (TCR) are established by the North American Association of Central Cancer Registries (NAACCR).  These guidelines are published in the Data Standards and Data Dictionary(Standards for Cancer Registries, Volume II).  This document presents standards for which cases are to be included in the registry, which data items are to be collected, and the source of standard for the coding rules of those items.

The Tennessee Cancer Registry also uses guidelines for cancer reporting based on suggestions by the National Cancer Institute-Surveillance, Epidemiology, and End Results (SEER) Program, the American College of Surgeons (ACoS), the American Joint Committee on Cancer (AJCC), and the Collaborative Staging Task Force of the American Joint Committee on Cancer.  The guidelines are published in the current versions of the SEER Program Coding & Staging Manual, the Facility Oncology Registry Data Standards (FORDS), the American Joint Committee on Cancer- Cancer Staging Manual, the Collaborative Staging Manual and Coding Instructions, and the SEER Summary Stage 2000 Manual.

The use of each of the following manuals is REQUIRED when abstracting and submitting data to the TCR.

1. Report all histologies with a behavior code of /2 or /3 in the International Classification of Diseases for Oncology, Third Edition (ICD-O3) except those listed in the Exceptions area below . Additionally, please note the following reportable conditions:
   • Carcinoid, NOS of the appendix is reportable.  As of 1/1/2015, the ICD-O3 behavior code changed from /1 to /3.
   • Intraepithelial neoplasia, grade III
     • Examples (not a complete list):
       • Anal intraepithelial neoplasia III (AIN III) of the anus or anal canal (C210-C211)
       • Laryngeal intraepithelial neoplasia III (LIN III) (C320-C329)
       • Lobular neoplasia grade III (LN III)/lobular intraepithelial neoplasia grade III (LIN III) breast (C500-C509)
       • Pancreatic intraepithelial neoplasia (PanIN III) (C250-C259)
       • Penile intraepithelial neoplasia, grade III (PeIN III) (C600-C609)
       • Squamous intraepithelial neoplasia, grade III (SIN III) except cervix
       • Vaginal intraepithelial neoplasia, grade III (VAIN III) (C529)
       • Vulvar intraepithelial neoplasia III (VIN III) (C510-C519)
       • Glandular intraepithelial neoplasia III of the pancreas (PAIN III)
   • Intraductal papillary mucinous neoplasm with high grade dysplasia (8453/2)
   • Pancreatic neuroendocrine neoplasm (PanNet) (8240/3)
   • Pancreatic endocrine neoplasm (PanNet) (8240/3)
   • Solid pseudopapillary neoplasm of pancreas (8452/3) is synonymous with solid pseudopapillary carcinoma (C23._)
   • Cystic pancreatic endocrine neoplasm (CPEN).  Metastases have been reported in some cystic pancreatic endocrine neoplasm (CPEN) cases.  With all other pancreatic endocrine tumors now considered malignant, CPEN will also be considered malignant, until proven otherwise.  Most CPEN cases are non-functioning and are REPORTABLE using histology code 8150/3, unless the tumor is specified as a neuroendocrine tumor, grade 1 (8240/3) or neuroendocrine tumor, grade 2 (8249/3)
   • For cases diagnosed January 1, 2010 onward, all histologies in the WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (2008) with a behavior code /3 are reportable.  Instructions for determining reportability for hematopoietic and lymphoid neoplasms are located in the Reportability Instructions of the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual.  The manual is available online at:http://seer.cancer.gov/seertools/hemelymph/ (Use the 2015 version of the manual for diagnosis dates 1/1/2010 onward). Use of the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual for hematopoietic and lymphoid neoplasms is REQUIRED. 
   • Pilocytic/Juvenile astrocytomas are reportable.  Code the histology and behavior code as: 9421/3.
   • Urine cytology positive for malignancy is reportable:
   • Code the primary site to C689 in the absence of any other information.
     • Exception: When a subsequent biopsy of a urinary site is negative, do not report the case.
   • Non-invasive mucinous cystic neoplasm (MCN) of the pancreas with high-grade dysplasia is reportable. For neoplasms of the pancreas, the term MCN with high-grade dysplasia replaces the term mucinous cystadenocarcinoma, non-invasive.
   • Mature teratoma of the testes in adults is malignant and reportable as 9080/3, but continues to be non-reportable in prepubescent children (9080/0).  The following provides additional guidance:
     • Adult is defined as post puberty
     • Pubescence can take place over a number of years
     • Do not rely solely on age to indicate pre or post puberty status.  Review all information for documentation of pubertal status.  When testicular teratomas occur in adult males, pubescent status is likely to be stated in the medical record because it is an important factor of the diagnosis
     • Do not report if unknown whether patient is pre or post pubescence.  When testicular teratoma occurs in a male and there is no mention of pubescence, it is likely the patient is a child, or pre-pubescent, and the tumor is benign.
     • Gastro-intestinal stromal tumors (GIST) and thymomas are frequently non-malignant. However, they must be reported and assigned a Behavior Code of 3 if they are stated to be malignant, noted to have multiple foci, metastasis or positive lymph nodes. 
   • Effective with cases diagnosed 1/1/2004 onward, benign and borderline primary intracranial and CNS tumors with a behavior /0 or /1 in the ICD-O-3 are reportable for the sites listed in the table below:

✔  Note: Neoplasm and tumor are reportable terms for brain and CNS because they are listed in   ICD-O-3 with behavior codes of /0 and /1.

✔  Note: Benign and borderline tumors of the cranial bones (C410) are not reportable

❖ Exceptions:

1. Prostatic intraepithelial neoplasia (PIN III) of the prostate (C619) is not reportable.
2. Carcinoma in situ of the cervix (/2) or cervical intraepithelial neoplasia (CIN III) of the cervix is not reportable by hospitals and surgery centers.
3. Malignant (In-Situ or Invasive) primary skin cancers with a primary site code C440-C449 and any of the following histology codes are not reportable:  

• Malignant neoplasm (8000-8005)
• Epithelial carcinoma (8010-8046)
• Papillary and squamous cell carcinoma (8050-8084)
• Basal cell carcinoma (8090-8110)
• AIN III (8077) arising in perianal skin (C445)

✔ Note:  Squamous cell carcinoma originating in a mucoepidermoid site must be reported to the TCR.  These sites are:               

                                                Lip          C00.1 – C00.9                     Vagina                  C52.9

                                                Anus      C21.0                                     Prepuce               C60.0

                                                Labia      C51.0 – C51.1                     Penis                     C60.1-C60.9

                                                Clitoris  C51.2                                     Scrotum               C63.2

                                                Vulva     C51.9