Reporting Manuals

https://seer.cancer.gov/tools/codingmanuals/historical.html .

For updates and errata to ICD-O-3 see the NAACCR website at https://www.naaccr.org/icdo3/#1582820761130-74100b9f-e677 .

As the coronavirus 2019 (COVID-19) pandemic continues, people with compromised immune systems are at an increased risk for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19. Based on the National Cancer Institute (NCI), more than 15,700,000 people are estimated to be living with cancer in the United States. Incidence of COVID-19 has been reported to be higher among cancer patients than in the general population. Additionally, recent studies have shown patients with cancer had higher observed death rates, higher rates of ICU admission, and higher risk of complications when compared to non-cancer patients. Radiotherapy, chemotherapy, and immunotherapy may be postponed to decrease the risk of infection of COVID-19 or increase in treatment co-morbidity. A technical report stated that 8% of cancer patients had alterations in treatment plans due to COVID-19. These patients had delays in treatment and for almost half of these patients, treatment was indefinitely delayed or stopped entirely due to confirmed COVID-19 infections. Even with the small sample sizes of these studies, the COVID-19 pandemic has observable and potentially long-lasting effects on cancer outcomes. It is imperative to collect SARS-CoV-2 infection status and modifications to treatment for both incident and prevalent cases at the population-level, using the existing cancer surveillance infrastructure and standards. (see https://seer.cancer.gov/tools/covid-19/ for references page 13).

General Instructions for Documenting COVID-19 as Part of Regular Case Abstraction

Following the above rationale, the COVID-19 Data Abstraction Guidance (Guidance v1.0. available at https://seer.cancer.gov/tools/covid-19/COVID-19-Abstraction-Guidance.pdf provides directions for using NAACCR text data items and standards to collect information on cancer patients’ SARS-CoV-2 laboratory tests, infection status, and delays or modifications of the treatment plan (Page 4-12, 14-15). The implementation of this guidance will take advantage of existing data items and text blocks, with minimal additional efforts for collection of COVID- 19 information. Meanwhile, the abstraction of COVID-19 information will not require changes to case ascertainment, reportability rules, list of required data items, modifications of edits metafiles, or other alterations of the current data acquisition process. In the application of directions listed in the Guidance, there is no expectation that registrars seek medical documents beyond the sources they currently use routinely for case abstraction and coding.

Abstracting Instructions

The following directions for recording COVID-19 information in the required NAACCR text data items are applicable to cases diagnosed January 1st, 2020, or later and completed on or after June 1st, 2020. COVID-19 Information must be entered in the text fields shown below to facilitate data retrieval. Entering text in a way that is different from this guidance (page 4-12 and as available on https://seer.cancer.gov/tools/covid-19/COVID-19-Abstraction-Guidance.pdf will make the information useless. Please follow the instructions for entering COVID-19 information in the following eight required NAACCR text data items.

TEXT DX PROC--LAB TESTS (NAACCR # 2500)
TEXT REMARKS (NAACCR # 2680)
RX TEXT SURGERY (NAACCR # 2610)
RX TEXT RADIATION (BEAM) (NAACCR # 2620)
RX TEXT RADIATION Other (NAACCR # 2630)
RX TEXT CHEMO (NAACCR # 2640)
RX TEXT HORMONE (NAACCR # 2640)
RX TEXT BRM (NAACCR # 2640)

COVID information is not required by SEER for cases diagnosed in 2023 and forward.

Cancer Recurrence

The National Cancer Institute estimates there are over 17 million cancer survivors in the United States today and these numbers are rising rapidly thanks to advances in early diagnosis and treatment. Georgia’s cancer registries are on the frontline in facilitating the capture of the necessary data to monitor our state’s progress in cancer prevention and control. Registries also provide clinical data that is critical to our research community. As our survivor population grows, it is ever more important that we capture additional outcomes to assess progress in life following a diagnosis of cancer.

Effective with cases diagnosed 2013 forward, the Georgia Cancer Registry is adding recurrence to its list of reportable data. We know that facilities participating in the Commission on Cancer Program have been collecting some data on recurrence for years but we need to expand the collection to all patients in our state and ensure that patients are followed for recurrence regardless of where they receive their future cancer care. As part of this new reporting mandate, we are not asking for any additional work on behalf of our cancer registrars in Georgia. The Georgia Cancer Registry is building an infrastructure to utilize data streams to provide signals of cancer recurrence. These signals will be validated by Georgia Cancer Registry staff on a sample of patients and then the algorithms defining the recurrence signals will be refined to improve their accuracy. This iterative process will continue until the algorithms are optimized. Once optimized, the Georgia Cancer Registry will share the recurrence data we have collected with any interested facility in Georgia for their respective set of cancer patients in the registry.

To minimize the burden of this work on cancer registrars in our state, we will be conducting the recurrence signal validation ourselves as discussed above. Our Regional Coordinators will be reaching out to you to facilitate setting up periodic access for GCR staff to visit your facility to conduct the validation. We know this does require some advanced planning to establish a space for our staff to work and as such we will reach out well in advance to ensure ample time to prepare. If there is any possible way to facilitate remote access for Georgia Cancer Registry staff to complete this work, we would greatly appreciate this and will complete any necessary paperwork that is required. We can provide a log of all cases that will be reviewed if that would be helpful along with any other information that is required.

This section in GCR Policy and Procedure Manual for Reporting Facilities can be found in link: https://seer.cancer.gov/manuals/2024/appendixc.html . This is a live link and will have the current codes and rules by primary site.

This information brings together the site-specific instructions needed to abstract a case. The Site-Specific Coding Modules include the following sections/documents for each primary site grouping:

• *Coding Guidelines document whenever there are guidelines for a primary site
• *Solid Tumor Rules
• *2018 EOD Schemas
• *Surgery codes

For older surgery code manuals use the following link: http://www.seer.cancer.gov/tools/codingmanuals/historical.html

Scroll down until you see “Surgery”.

There are two historical manuals available for reference:

1. Diagnostic Procedures April 1997, effective 1997- 1987
2. Site-Specific Surgery Codes, effective 1983- 1997

Surgery codes for 1998 – 2022 are in Appendix C of the SEER Program Code Manual (SPCM), 3rd Ed., located in historical manuals section.

This section of the GCR Policy and Procedure Manual for Reporting Facilities can be found in the SEER 2024 Solid Tumor Rules . This is a live link and will have the current Multiple Primary/ Histology Rules. Use this reference when a Primary site does not have its own set of Multiple Primary/Histology rules.

Historical Cases for diagnosis years 1995 through 2022. Refer to SEER Historical Staging and Coding Manuals .

List of Paired Organ Sites

Refer to pages 109-110 in the SEER Program Coding and Staging Manual 2024 .