Quality Improvement Tools

Members of the cancer registrar community use this tool to submit questions to NCI SEER about coding cancer cases and about materials that are distributed through the SEER website. The questions are answered by NCI SEER expert staff. The question and answer may be added to the SEER Inquiry System for others to reference.

NCI SEER offers educational opportunities throughout the year, including the SEER Advanced Topics for Registry Professionals workshop. This widely acclaimed workshop is open to all cancer registrars and is held annually. The workshop provides advanced, in-depth training for registrars on topics of interest and importance to the registry community. Additionally, many educational opportunities such as free online presentations are available through the SEER website.

SEER*Educate and the SEER Training Website offer free online education.

SEER*Educate Provides hands-on exercises for new and experienced cancer registrars. Answers with detailed rationales are provided. Continuing Education credits are available for some sections.

SEER Training Website Educational modules on a variety of cancer registry topics, including cancer registration & surveillance and site-specific modules, are available and include illustrations, tables, and graphs.

CPC*Search is an interactive webtool that allows cancer registrars and other users to search the 2024 Cancer PathCHART ICD-O-3 Site Morphology Validation List (CPC*SMVL) validity standards by tumor site, histology, and behavior terms and associated codes.

The Hematopoietic and Lymphoid Database is an interactive web-based tool that supplements the Hematopoietic & Lymphoid Neoplasm Coding Manual to assist cancer registrars in screening for reportable cases, coding the primary site and histology, and determining the number of primaries to report. The database contains abstracting and coding information for all hematopoietic and lymphoid neoplasms.

The Manual Reference Guide provides a list of current manuals with links and information about where to submit questions on topics related to a specific manual.

The SEER Quality Improvement team is currently developing a new methodology to assess record consolidation at the central cancer registry level. The goals are to obtain an accurate measure of the data quality in the consolidated record and to identify opportunities for quality improvement while using NCI SEER resources as efficiently as possible.

2018 EOD Consolidation Manual (PDF, 4.7 MB) The purpose of this manual is to inform the cancer registrar at the central registry how to manually consolidate the three core EOD data items for each schema when there are different source values. The consolidation instructions assume that critical data items on the records have already been reviewed and consolidated, including primary site, histology, and behavior.

The SEER Abstracting Tool (SEER*Abs) is a configurable data collection tool that allows cancer registrars to collect and store data abstracted from patients’ medical records.

The SEER Data Management System (SEER*DMS) provides support for all core cancer registry functions - importing data, editing, linkage, consolidation, and reporting. The individual SEER Registries actively participated in the requirements analysis and design of SEER*DMS. SEER*DMS improves cost efficiency and reduces duplication of effort in terms of system maintenance and administration. From 2017-2019, SEER invested in extensive usability testing of SEER*DMS to improve user experience, reduce cognitive overload, and enhance the overall usability of SEER*DMS. As further developments and enhancements are made to SEER*DMS, SEER continues to invest in targeted usability testing. Furthermore, the centralized system design and development of SEER*DMS improves data quality and consistency, increases efficiency, and increases the sharing of knowledge and experience among registries. Current and future development of SEER*DMS is handled by the Change Control Advisory Board.

The SEER*Edits are an extensive set of field, inter-field and inter-record edits provided by the SEER Program and maintained by the NAACCR EDITS Committee. SEER*Edits are distributed as part of the NAACCR-EDITS Metafiles. SEER*Edits are used to identify and correct errors in data via the following software: GenEdits, SEER*Edits, SEER*Abs, and SEER*DMS. The SEER Program also developed the SEER*Edits engine to validate incidence data stored in a variety of data formats including, text files and database structures. The edits engine is a software module that can be used by Java-based programs. SEER*Edits software is not distributed to the public.

The SEER Inquiry System (SINQ) is an interactive online repository of questions submitted by designated registrars in SEER registries with answers from NCI SEER experts. The answers go through a rigorous review process by NCI SEER staff and designated SEER registry staff before being added to SINQ. The questions and answers can be searched and viewed by all registrars.

This manual covers data items required by SEER. Instructions about reportability, ambiguous terminology, and many other important registry topics are included. Clear coding instructions and numerous examples contribute to high quality data. Previous versions of the manual are available in the historical manuals section.

The Registrar Staging Assistant (SEER*RSA) website is used by cancer registrars to code Extent of Disease (EOD), Summary Stage, Site-Specific Data Items (SSDIs), and TNM or CS data items, as appropriate. In addition to the website, SEER*RSA data are provided via both an API and software libraries.

Beginning with cases diagnosed January 1, 2018, and forward, SEER registries collect Extent of Disease (EOD) information for every cancer case. Three main data items comprise EOD: EOD Primary Tumor, EOD Regional Nodes, and EOD Mets. These, combined with SSDIs and other data items that are related to staging, provide a standardized description of stage for all cases including many not eligible for AJCC TNM staging.

Summary Stage is the most basic way of categorizing how far a cancer has spread from its point of origin. Historically, Summary Stage has also been called General Stage, California Stage, historic stage, and SEER Stage. The 2018 version of Summary Stage applies to every site and/or histology combination, including lymphomas and leukemias. Summary Stage uses all information available in the medical record; in other words, it is a combination of the most precise clinical and pathological documentation of the extent of disease.

The Pediatric Data Collection System (PDCS) was developed to collect Pediatric staging and site-specific data item (SSDI) information. The staging elements collected are based on the Toronto Childhood Cancer Staging Guidelines, Version 2, along with additional data items for surveillance purposes. The PDCS also allows for expansion to develop further staging and clinically significant information for pediatric cancers.

SEER*Rx is an online interactive antineoplastic drug database developed as a comprehensive resource for coding oncology drug and regimen treatment categories for cancer registry data collection. Updates to the tool are based on FDA notifications and the most up-to-date information is available from any computer or device with an Internet connection.

The Solid Tumor Rules provide site-specific multiple primary and histology rules to promote consistent and standardized coding by all cancer registrars in North America. The solid tumor multiple primary rules standardize the process of determining the number of primaries. The histology rules contain detailed site-specific histology coding instructions.

NCI SEER uses benchmarking to assess individual data items against a reference point by registry. Benchmarking can be used to assess missing data (percent unknown), precision (percent not otherwise specified), and validity. Results of benchmarking can be used to create edits or flags in SEER*Abs or in SEER*DMS. Results are also used to expand understanding of expected distribution for a given data item.

The Cancer Medications Enquiry Database (CanMED) is a two-part resource for cancer drug treatment related studies. It is intended to facilitate cancer surveillance, epidemiology, and pharmacoepidemiology research that uses the National Drug Code (NDC) and Healthcare Common Procedure Coding Systems (HCPCS) nomenclatures.

The Data Quality Profile is a quality improvement tool which is generated annually for each SEER registry. This profile assesses the extent to which each registry provides data meeting certain contractual requirements and other standards. For example, the DQP reports the percent of cases for which a specific data item is coded unknown and compares that result to the desired goal. NCI SEER establishes ambitious DQP goals to set a high bar for data quality. Top performing SEER registries are able to meet or exceed all DQP goals. Registries with exceptional DQP results are recognized.

Numerous files are available showing the conversions between ICD-O-1, ICD-O-2, ICD-O-3, ICD-9, and ICD-10. Information for ICD-10-CM (effective 10/01/2015 in the U.S.) is also available.

Developed as a systematic way of evaluating the quality of existing and potential SEER data, a Quality Audit Plan (QAP) is a standardized framework for verifying and validating such data with respect to completeness, consistency, and precision or accuracy.