CTR Exam-Data Collection (Abstracting/Coding)-55%

The process of converting the medical record information into standardized codes within a uniform data set is

Pediatric tumors are analyzed by _____ rather than origination site.

Benign and borderline CNS and brain tumors became reportable effective_____

All benign/borderline Central Nervous System (CNS) and Intracranial (brain et al) tumors with a behvior code of /0 and /1 and all cases with a behavior code of /2 and /3 in ICDO-3, except: squamous and basal cell carcinomas of skin (after 01/01/2003)(except reproductive), Carcinoma In Situ of cervix and Intraepthelial neoplasm of cervix (CIN) III , prostate (PIN) III, vulva (VIN) III, vagina (VAIN) III, and anus (AIN)III. (after 01/01/1996)

Analytic cases

Non-analytic cases

Examples of ____sources: pathology reports disease index medical record reports radiation oncology logs medical oncology logs outpatient records radiology reports other hospitals, nursing homes, out of state facilities, hospitces, outpatient centers, physician offices, death clearance

Date of first contact

Non-Reportable diagnoses

Systematic method for identifying all eligible cases to be included in the cancer registry database

Death certificate only benchmark rates by CCR agencies

Casefinding timliness benchmark rates for NAACCR, SEER, NPCR

Ambiguous terms that constitute a diagnosis

T or F? Abstract cytology with ambigous term only if positive biopsy or physician clinical impression of cancer support cytology findings

Ambigous terms that DO NOT constitue a dx of CA without add'l information

Requests from the facility's cancer committee or central registry to collect information about tumors that are not required to be abstracted by the CoC for accredited programs are called____cases.

Class of case -- to --are analytic cases

Class of case -- to -- are included in treatment and survival analysis

Analytic class of case -- dx on or after January 1, 2006 are not required to be staged or followed

class of case --to-- are non-analytic

The CoC does not require registries to accession, abstract, or follow class of case -- to -- but the program or central registry may require them

The date the registry database started which is always January 1

What is the CoC's retention timeframe

The accession number is a 9 digit number first 4 digists represent

The accession number is a 9 digit number last 5 digits represent

The sequence 00 means the patient has ____malignant primary cancer

The sequence numbers are divided into 2 groups ___ and ____

GISTS with mets, positive LNs or ________ must have behavior changed to /3 and be abstracted

Brushings, washings, cells aspirates are not _________ procedures

Excisional biopsies of primary site are coded as_____procedures

Do not code procedures that excise, aspirate or remove lymph nodes to diagnose or stage cancer in "surgical diagnostic staging procedures". Code as_____

____ staging rules: Information obtained before treatment or within 4 months of date of diagnosis (whichever is shorter)

___staging rules: Information through the first course surgery or within 4 months of date of diagnosis (whichever is longer)

___reporting is considered when cases are need for epidemiologic protocls, research or tumor board presentation at hospitals. Using this method cases are identified within___days.

Local recurrence

trocar recurrence

regional recurrence

distance recurrence

suspense system

What is the follow-up percentage maintenance rate for all analytic patients from the cancer registry's reference date?

What is the follow-up percentage maintainance rate for all analytic patients within the last 5 years?

The group of data items required to be collected by a standard setting organization

What are the 3 major objectives of a cancer registry?

If 2 malignancies are diagnosed at the same time, assign the lowest sequence number to the tumor with the worst_____. If no difference, assignment is arbitrary.

Sequence 00 to 59 and 99

Sequence 01

Sequence 60 to 88

Sequence 60

Sequence 61

The Cancer Identification section of the abstract contains data items that describe the disease and contains additional administrative information, which includes:

The Stage of disease at diagnosis contains the data items that identify, confirm and support the assigned stage of disease, which includes:

The Patient identification of the abstract consists of items that identify the patient or descriptors and include:

The ______section of the abstract contains data items that describe the surgical procedures, radiation therapy, chemotherapy, hormone therapy, immunotherapy (biologics), hematologic transplant and endocrine procedures, pallative procedures.

The ___section of the abstract consists of the follow up data items, date of first recurrence, type of first recurrence, date of last contact or death, vital status, cancer status, following registry, follow up source, and next follow up source

The demographic section of the abstract contains:

The ____section of the abstract contains override flags, coding system used to abstract case, reporting facility, abstractor who coded case.

Data collected by____provide: a source for planning and evaluating patients administrative planning by cancer committee and physicians used by government and private entities to develop cancer control programs investigate cancer research

Topography

Morphology

staging

Patients with date of contact > 15 months after date of last contact have been____

One disadvantage of changing the reference date is

To be considered for initial CoC survey, the cancer registry database must have ___complete years of data

An annual sequential listing of all eligible cases included in the registry database is a definition of

A summary of pertinent information about the patient, cancer diagnosis and treatment, and patient follow up is a definition of

A minimum of __________ of the annual analytic caseload should be reviewed for accuracy, completeness, and timeliness by a physician.

A group of diseases in which cells grow and spread unrestrained throughout the body

Cancer of the immature blood cells that grow in the bone marrow and tend to accumulate in large numbers in the bloodstream

The ability of cancer cells to penetrate into lymphatic and blood vessels, circulate through the bloodstream, and then invade normal tissues elsewhere in the body

Cancer of the glands

Tumor that is capable of spreading by invasion and metastasis

A malignant tumor that arises from the cells that cover external and internal body surfaces and is composed of epithelial cell

Loss of normal tissue arrangement and cell structure

Grouping of cases with similar prognosis

Determining how closely a cancer cell resembles normal cells

"new growth"

A cancer that arise in the lymph nodes and tissues of the body's immune system

Tumors that have not invaded the basement membrane

A cancer arising in the bone

Cancer that arises in plasma cells of the bone marrow

Tissue growth leading to a larger than usual number of cells in which cell structure and arrangement remain normal

The direct migration and penetration by cancer cells into neighboring

Structure that supports an overlying epithelium or endothelium

A cancer that arises from cells found in the supporting tissues of the body such as bone, cartilage, fat, connective tissue, and muscle

Encapsulated tumors that do not invade other tissues or organs

How far the disease has spread from the primary site

Malignant tumor of blood vessels located in the skin. People who develop AIDs after HIV are at high risk for developing.

Tumors that have gone beyond the basement membrane

Causes of cancer

Prevention or reversal of disease using drugs, chemicals, vitamins or minerals

Sebacious gland produces

sudoforius gland produces

ceruminous gland produces

Endoscopic* & clinical esophagus descriptors (3)

Radiographic and intraoperative esophagus descriptors (3)

6th digit grade code for T-cell lymphoma/leukemia

6th digit/grade code for B-cell lymphoma/leukemia

Well-differentiated/Differentiated, NOS- Grade I

Moderately differntiated/moderately well differentiated/intermediate differentiated-Grade II

Poorly differentiated Grade III

Undifferentiated/anaplastic Grade IV

Grade or differentiated not determined or not applicable

When did ICDO-3 become effective?

Slender flexible, lighted tube used to examine the rectum and PART of the colon

slender, long, flexible, lighted tube used to examine the ENTIRE colon

The discover of the _____led to the pathological study of cancer and the birth of oncology

Grade for carcinoma in situ is always

"foci of invasion" , "microinvasive" make the tumor

MPH timing rules for melanoma, colon, lung, breast

Do not use the physician's statement of recurrence v.

new primary, unless pathologist ________

MPH rules: If tumor described as "multifocal" or "multicentric" use ______rules

MPH rules: If tumors with separate microscopic foci, ignore and use _____rules

A single tumor that involves, invades, or bridges adjacent or connecting sites or subsites.

An adjective meaning limited to one specific area. A focal cancer is limited to one specific area or organ. The area may be microscopic or macroscopic.

A term used by pathologists to describe a group of cells that can be seen only by a microscope.

The cells are noticeably different from the surrounding tissue either by their appearance, chemical stain, or other testing. Laterality:

Plural of focus.

Indication of which side of a paired organ/site a tumor is located.

The pathologic specimen from the surgical procedure that removed the most tumor tissue.

The involved sites are adjacent (next to each other) and the tumor is contiguous.

This term has two meanings: 1. The reappearance of disease that was thought to be cured or inactive (in remission). Recurrent cancer starts from cancer cells that were not removed or destroyed by the original therapy. 2. A new occurrence of cancer arising from cells that have nothing to do with the earlier (first) cancer.

A new or another occurrence, incidence, episode, or report of the same disease (cancer) in a general sense - a new occurrence of cancer.

The _______general rules do not apply to hematopoietic primaries (lymphoma and leukemia) of any site or to the reportable benign or borderline intracranial or CNS tumors.

MPH site specific rules for these sites____ and use "other sites" for all other solid tumors.

_____tumor can arise anywhere in the kidney tissue. This tumor typically appears in children between 2-5 years of age.

Adenocarcinoma, intestinal type (8144) is a form of stomach cancer.

Do not use this code when the tumor arises in the ______.

98% of colon cancers are

Must have > ---% mucinous to code mucinous adenocarcinoma in the colon

MPH colon rules: exophytic" and "polypoid" are not synonymous with______.

Adenocarcinoma arising from the colon wall (no evidence of a polyp) =

Rectum and rectosigmoid are covered by The Other Sites rules(not the colon site rules) . True or False?

Frequently a patient may have two or more tumors in one lung and may have one or more tumors in the contralateral lung. The physician may biopsy only one of the tumors.

Code the case as _______ tumor unless one of the tumors is proven to be a different histology

MPH Lung rules: Do not base multiple primary decision on this phrase; It does not mean this is a single or multiple primary.

A villous adenoma is a

The middle dividing line that separates the body into right and left sides.

Most common cancer in women

Most common cancer in men

Second most common cancer in men and women. Leading cause of total cancer deaths

Third most common cancer in men and women.

Second leading cause of cancer deaths

After breast, lung and colon cancer the most common cancers in women are (2)

After prostate, lung, colon cancer, the most common cancers in men are (2)

RT-PCR (Reverse Transcriptase Polymerase Chain Reaction)

CISH (chromogenic in situ hybridization)

IHC (immunohistochemistry)

FISH

Subsequent (secondary) treatment

Adjuvant therapy

Neoadjuvant therapy

Fractionation

1 gray=___rads

1 cGy=____Gray

Radiation treatment volume

Location of radiation treatment

Regional treatment modality

Regional dose:cGy

The Number of treatments to this volume

Chemotherapy

Boost treatment modality

Boost dose:cGy

Chemotherapy treatment cycle

Chemotherapy regimen

Alkylating agents

Antimetabolites

Natural agents

Misc chemotherapy agents

Only code ____as cancer directed hormone therapy when administered in combo with chemo. Eg. CHOP

Drugs that mimic the actions of hormone releasing factors

Drugs that inhibit the actions of hormone releasing factors

In men, ____hormone surpresses LH blocking testosterone and used to treat advanced prostate cancer

Antihormones

Aromatase inhibitors (anti estrogens)

Radiation and/or surgery must be bilateral to qualify as ______surgery, unless only 1 gland is intact.

Do not code hormone replacement therapy as cancer directed hormone therapy , except for______.

The timeframe for calculating survival starts when there is a diagnosis of a _______tumor

MPH rules: there are 3 sections in MP section

MPH rules: there are 2 sections in H section

Only ____tumors are included in nationally published incidence data

A single tumor is a single primary when

_____stage primarily used by central registries that report to NPCR

______stage is not well understood by physicians

Summary Stage went into effect

Summary Stage one digit code from 1 to

Summary Stage 0=

Summary Stage 1=

Summary Stage 2-5=

Summary Stage 7=

Summary Stage 9=

For _____ cancer, any mention of LN s equals involvement

For _____tumors, fixed or matted and/or a mass in the mediastinum, retroperitoneum and/or mesentary means LNs are involved

Enlarged LNS or lymphadenopathy considered involved LNs only for ____cancer.

Malignant cells released into bodily fluid. E.g. Peritoneal, ascites

Common mets sites

Diagnostic confirmation for bone marrow biopsies/asirations of any site should be coded as positive ______findings

Hematologic confirmation of leukemia only by peripheral blood smear, CBCs, WBCs, should be coded as positive _________________confirmation

3 Conditions must be met for the "inaccesible Lymph Node rule" (i.

e. Can code 00 no lymph node involvement).

Accessible lymph node rule applies to palpable lymph nodes

SEER EOD Stage ended 12/31/2003 and was replaced by SEER___Stage effective 01/01/2004.

SEER EOD stage consisted of a 10 digit code. a.

3 digits for ______ b. 2 digits for ____ c. 1 digit for ___ involvement d. 2 digitis for # of ______ positive Reg LNs e.

2 digits for # Reg LNs examined _______

What was the con of SEER EOD staging?

SEER Summary Stage 2000 went into effect 01/01/2001. It consists of a ____digit code

SEER Summary Stage codes: a. 0 or _____= within the cells, only pathologically confirmed b. 1 or ____=limited to organ of origin c. 2-5 or ____=beyond the organ of origin (1.

direct extension; 2. involving Reg LNs, 3. combo of 1. and 2.) d.

7 or ____=Cells broke away from primary site and traveled. e. 9 or _____

T or F? Lymphoma can arise in any site

What are the 4 lymphatic structures

What are the common extra lymphatic sites lymphoma arises in? (6)

When multiple LN chains are involved with lymphoma code to

When there are multiple LNs involved in one LN chain for lymphoma code to that chain

extranodal site and regional LN involvement for lymphoma code the primary site as

If its suspected that lymphom is extra nodal and known not to arise in the LNs, and no site is given code to

?-cells transform into plasma cells and secrete antibodies that attache to the infection and causes it to die. ?-cells go straight from the bone marrow into the lymph system

? cells are formed in the thymus gland an attack foreign substances by engulfing it with a toxic effect

For hematopoietic primaries the 6th digit is not grade/differentiation but the immunophenotype based on ____type

For lymphomas, the number of _______involved affects the site code. The number of _____involved affects the stage.

For Lymphoma, Bilateral nodal involvement is considered two regions for ____purposes

Bilateral involvement of a paried extra-nodal organ for ______is considered a single organ

Any mention of enlarged lymph nodes (palpable, enlarged, visible swelling, shotty, lymphadenopathy) is considered involved for these 2 sites only

equivocal means

Leukemias grouped by how quickly the disease develops or gets worse (2)

Leukemais are grouped by type of white blood cell affected (2)

2 More common type of leukemia among children

Non-malignant tumors must originate in the ___ and ____, not in the skull or vertebrae (bone) to be reportable

Rathke pouch (craniopharyngioma) is located in the ______ reportable as a brain related benign tumor

Chondroma must origniate in a ___related site (not the skull, ie.

bone) to be reporable

True or false ? Chordoma (not chondroma) is a malignant tumor arising from the embryonic tissue; malignant tumor of the cartilage cells and is reportable.

True or false? For non-malignant brain/CNS tumors only, Count ALL non-malignant CNS tumors over the lifetime of the patient, even if diagnosed prior to 2004.

True or false? Refractory Anema did not become reportable until 01/01/2001

True or false? There is no AJCC TNM staging for any of the brain schema sites.

Superior vena cava syndrome is associated with which type of cancer?

Which body cavaties are frequently checked for cancerous involvement of cells in fluid?

____imaging uses a scan using pencil thin radiation beam for a slice or cross section of the body, to create a series of pctures taken from different angles

___imaging uses a scan taking cross-sectional slices (views) from many angles, using magnets

___imgaing produces shadow-like images of bones and certain organs and tissues

____imaging used for persons diagnosed with breast cancer or at a high risk for breast cancer

___scans make pictures based on the body's chemistry rather than on physical shapes using liquid substances called radionuclides/radiopharmaceuticals/tracers that release low levels of radiation

Other studuies that use idodine based dyes/contrast (2) examples

tumor marker CA 125 is used in screening for ___cancer

tumor marker CA19-9 is used in screening ___ cancer

tumor marker CA 549 is used in screening for___cancer

tumor marker CA 195 is used in screening for ___cancer

tumor marker CEA is used in screening for any

tumor marker CA 15-3 is used in screening for ___cancer

___procedures in clude endoscopic and operative explorations that examine the body through and opening or small incision

The most widley used tumor marker to help screen for cancer in the general population

In determining sequence number, make sure first malignancy was reportable at the time of the new malignancy diagnosis (except for benign brain/CNS tumors).

For example polycythemia vera was not reportable until 2000. true or false?

When determining class of case, first course treatment options include "recommended but refused" and "not recommended". true or false?

Any first course treatment, whether curative or pallaiative is used for determining class of case. true or false?

For class of case, pathology specimens read in pathology the date should be 1.

the date of procedure or, 2. the date the pathology was received or read?

If the patient was seen at the facility for a radiation consult, the date of the first contact would be the date of the consult if ____ was developed at that time.

Estimating dates-Spring =

Estimating dates-middle of the year=

Estimating dates-Fall=

Estimating dates-winter=

Most paired sites cannot develop a midline tumor with the exception of____

Bone marrow aspirations or biopsies of any site are considered ____diagnostic confirmation

Peripheral blood smears, CBCs, and WBCs for leukemia only are considered____diagnostic confirmation

If work-up negative on the visit, but positive on a later visit the date of first contact would be___.

According to FORDS, the date of diagnosis is the____

Prostate CA: Average age at the time of diagnosis

___syndrome, also known as hereditary non-polyposis colorectal cancer or HNPCC, inherited gene changes having an increased risk for a number of cancers including prostate cancer

Certain genes that cause cells to grow, dividie, stay alive

Genes that slow down cell division, repair mistakes in DNA or cause cells to die at the right time

Prostate cancer metastasizes to where first?

Prostate CA: which has priority for grading/6th digit? Gleason score or terminology (eg.

well-differentiated)

Which is the primary pattern? which is the secondary pattern? 4+3=7

Gleason score: If only one number is given and it is =<5, assume it describes the_____

Gleason score: if only one number is given and it is >5, assume it describes the____

Prostate CA: If there are multipble biopsies and Gleason scores. Code the ____score.

Prostate Ca: 10/10 Gleason the score is:

Prostate Ca: cN is determined via biopsy or imaging. For pN a __is required.

Prostate Ca: Code the highest ____value prior to diagnostic biopsy or treatment

Prostate Ca: TURP is a clinical staging method but is coded in SPPS (keep rules for data items separate!) T or F?

A Prostatectomy is required for pathological staging of the T. True or False?

Prostate Ca: ipsilateral, contralateral or bilateral involvemnt is regional for prostate LNs. true or false?

Prostate Ca: The pathologist should count cores, not fragments, chips, pieces, speciments or positive lobes.

Prostate Ca: non-regional LNs are:

Prostate Ca: regional LNs are:

Prostate Ca: Gleason 8-10= Grade:

Prostate Ca: Gleason 7=Grade:

Prostate Ca: Gleason 5-6=Grade:

Prostate Ca: Gleason 2-4=Grade

Prostate Ca: 2 types of radiation therapy treatment

Prostate Ca: HT therapy or Androgen Deprivation Therapy (ADT)

Prostate Ca: Common Chemo drugs used

Lung Ca: Most common mets sites:

Lung Ca: If biopsied primary tumor cannot be reomoved, and if the higest T and N or M1 categories of the tumor can be confirmed microscopically, ther criteria for pathologica staging may be met without resection. True or False?

Lung Ca: When term hilar, perihilar, infrahilar or soft tissue mass it should be considered Lymph Node involvement.

True or False?

Lung Ca: When term mediastinal mass it should be considered Lymph Node involvement. True or False?

Lung Ca: If Hilary Mass is only description, code to Hilum C34.0. T or F?

Lung Ca:

Left Lung has ___lobes

Right lung has ___lobes

2 membranes that surround the lungs:

Use ypT, ypN categoreis to pathologically stage after _____treatment

Lung Ca: presence of pleural effusion for lung only is enough to code M1a. Does not have to state malignant pleural effusion. T or F?

Lung Ca: Any lymphadenopathy, enlargement or mass of LNs=

Lung Ca: Staging procedures include:

Lung Ca: TX used when primary tumor cannot be assessed but it was proved to be lung ca based on presence of maligant cellsin sputum or washings.

T or F?

Lung Ca: T0pM1a : No evidence of lung lesion on imaging, yet pleural effusion biopsied & was malignant consistent with Ca. true or false?

Lung Ca: cases that have nodules in the contralateral lung are considered distant (M1a) disease. T or F?

Lung Ca: Common chemo drugs:

Lung Ca: Targeted therapies:

Breast Ca: T can be based on clinical or pathological, though pathological takes precedence. T or F?

Breast Ca: Must have resection or ___biopsy with neg or micro margins only for pathological T

Breast Ca: ____LNs reside within the breast tissue and are coded as axillary LNs

Breast Ca: Clinical diagnosis of ___breast cancer not enough.

Must be stated in final diagnosis of pathology report to be coded as such.

Breast Ca: satellite skin nodule or skin involvement includes:

Breast Ca: Distant mets includes:

Breast Ca: LNs positive for ITCs are not considered positive LNs. T or F?

Breast Ca: Pathological N is used for excision or sentinel LN biopsy only in conjunction with a pathological T assignment. T or F?

Breast Ca:____ are small clusters of cells not >0.2mm

Breast Ca:___ are tumor deposits >0.2 mm but not >2.

0 mm. They are designated as pN1mi

Breast Ca: No clinical/radiologic evidence of distant mets, but deposits of molecularly/microscopically detected tumor cells in circulating blood, bone marrow or other distan nodal tissue not >0.2 mm (circulating tumor cells-CTCs) are designated as cM0(i+) . True or False

Breast Ca: primary site for tumor that overlaps more than one quadrant

Breast Ca: primary site for tumor when quadrant is unknown or multiple tumors in different quadrants of the same breast

Breast Ca: A biopsy with macroscopically positive margins is an _____ biopsy and cannot be used for pathological staging.

Breast Ca: Simultaneous tumors in each reast are considered separate primaries per MPH rules. T or F

Breast Ca: ___disease with a palpable mass on clinical exam and with an invasive component on pathology is classified according to the invasive component.

Breast Ca: ___disease with a palpable mass on PE, but no invasive component on pathology is assigned Tis (DCIS or LCIS)

What are considered local therapies? (2)

What are considered systemic therapies? Drugs which can give given by mouth or directly to the bloodsream to reach cancer cells. (3)

Breast CA: common chemotherapy drugs:

Breast CA: Hormone treatments

Breast Ca: Targeted therapy (biologics/immuno)

Colon Ca: T category is not based on size, but depth of ____

Colon Ca: Tumors are either Frank/De Novo or arise in a

Colon Ca: TDs/Foci/satellite nodules in fat are to be recorded in the N category, if no other LN involvement described.T or F?

Colon Ca: Regional LNs depends on subsite of primary site

Colon Ca: Superior mesenteric LNs are Distant LNs for all colon subsites

Lung Ca: most common histologies (3):

The return or reappearance of the cancer after a disease-free interval

When a patient who was never disease-free develops further regional or distant mets

Use MPH Rules to determine if new primary or recurrence. What are the 2 exceptions to this rule?

Direct extension or distant mets that developed after the diagnosis was established, and ithe the ___plan is discontinued or changed due to a change in disese status is considered a progression of disease

What data items are followed until first recurrence? (2)

What data items are updated throughtout patients lifetime?

Epithelial tissue

Squamous cell carcinoma

Adenocarcinoma

Transitional cell carcinoma

Connective tissue

Muscle tissue

Nerve tissue

Medulla

Cortex

Parenchyma

Stoma

Synchronous

Metachronous

Precocious

Sarcoma

p53

AJCC General Rule: Biopsy of primary site only is classified as Clinical T, unless the biopsy provides the highest possible T category, in which case it may be classified as a Pathological T.

T orF?

AJCC General Rules: Pathological exam of a single LN in the absence of pathological evaluation ofthe primary tumor is classified as a Clinical N. T or F?

AJCC General Rules: Tumor sizes reported in smaller units than mm, such as a tenth or undreth of a mm should be round to the nearest whole mm for reporting staging. e.g. breast tuor of 1.2 mm should be recorded as 1 mm; 1.

7mm tumor should be reported as a 2 mm. T or F?

MPH RULES: 2 or more separate primaries, different topographical sites, same morphology=

MPH RULES: certain tumors which occur in multiple sites eg. Adenomatous polyps)=