Cancer PathCHART: Communications and Frequently Asked Questions

A: If registrars encounter a site-morphology combination that returns a validity status of "unlikely" or "impossible," they can search CPC*Search for similar terms that have different codes by tumor site and explore codes and terms by tumor site.

A: CPC*Search provides a convenient way to search tumor site-morphology combinations by histology term or International Classification of Diseases for Oncology (ICD-O) ICD-O-3.2 code, tumor site or ICD-O-3 topography code, behavior, and/or whether the combination is biologically valid (can be coded), unlikely (can be coded after a manual override), or impossible (cannot be coded).

A: If you encounter conflicting information in these coding resources and CPC*Search, submit a question to the SEER Inquiry System (SINQ) or Ask A SEER Registrar.

A: The first step is to confirm primary site. Once confirmed, review the medical record for alternative site-morphology combinations. If still unclear, consult the coding rules (e.g., Solid Tumor Rules or Hematopoietic Database). To determine if another code should be used for a histology term at a given tumor site, registrars can review CPC*Search results for similar terms with different codes by tumor site. If still unclear, submit questions to the SEER Inquiry System (SINQ) or Ask A SEER Registrar. If the tumor is still determined to be an unlikely site-morphology combination, enter the associated codes with a manual override.

A: The first step is to confirm primary site. Once confirmed, review the medical record for alternative site-morphology combinations. If still unclear, consult the coding rules (e.g. Solid Tumor Rules or Hematopoietic Database) and/or the pathologist or treating clinician. To determine if another code should be used for a histology term at a given tumor site, registrars can review CPC*Search results for similar terms with different codes by tumor site. If still unclear, submit questions to the SEER Inquiry System (SINQ) or Ask A SEER Registrar.

A: Report the impossible site-morphology combination to the SEER Inquiry System (SINQ) or Ask A SEER Registrar. The Cancer PathCHART team will review these combinations on a case-by-case basis to determine if the standards need to be changed.

A: For ICD-O-3.2 terms, only the preferred terms are included in the search tool. Synonyms and related terms are not included. For example, if a registrar enters primary site of “lingula” in term for primary site, a message indicating “No matching records found” would result. The registrar should use the International Classification of Diseases for Oncology, 3^rd Edition (ICD-O-3) manual to identify the preferred term “upper lobe lung,” as it is part of the upper lobe of the left lung or use the topography code “C34.1” to perform the search. The same logic would apply to a histology term that is not found in the search field.

A: Check the spelling of any terms entered. Typos can cause no results or incorrect results to return. Refrain from using abbreviations and acronyms. For example, spell out “neuroendocrine tumor” instead of typing “NET,” spell out “gastrointestinal stromal tumor” instead of typing “GIST,” etc. If a hyphen is sometimes used in the histology term, try entering the term with and without the hyphen. An example is entering "non-mucinous" in the histology term and "lung" as the site instead of "nonmucinous" in the histology term and "lung" as the site. If entering the histology code instead of the term for search criteria, confirm that all four digits of a histology code are entered. Partial histology codes will return no results.

A: Mistyping and coding the wrong International Classification of Diseases for Oncology, 3^rd Edition (ICD-O-3) codes for a site-morphology combination with similar terms and different tumor sites can result in coding errors. CPC*Search is an efficient way to explore the Cancer PathCHART tumor site-morphology standards to confirm whether a given site-morphology code combination assigned to a cancer case is biologically valid, unlikely, or impossible.

A: WHO terms are based on terms in the 5^th edition of World Health Organization (WHO) Classification of Tumours book published in print. If a histology term is included in this book for sites reviewed for implementation of the 2024 Cancer PathCHART ICD-O-3 Site Morphology Validation List (CPC*SMVL), it will appear in search results for a given site-histology combination. The term will only be available for site-histology combinations at tumor sites that were reviewed for the updated standards released in 2024. For a list of tumor sites reviewed for the 2024 CPC SMVL, see Primary Sites Reviewed for 2024 Implementation.

A: When researchers need to know which tumor types are biologically valid, they can search these standards to know which tumor site-morphology combinations could be included for a given organ site. Terms in the 5^th edition of the World Health Organization Classification of Tumours books are automatically biologically valid in CPC*Search.