Report | Question ID | Question | Discussion | Answer | Year |
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20250005 | Reportability/Behavior--Ovary: Is ovarian mucinous borderline tumor with foci of multifocal intraepithelial carcinoma reportable? |
Report ovarian mucinous borderline tumor with foci of multifocal intraepithelial carcinoma. The foci of intraepithelial carcinoma makes this reportable. See the list of synonyms for in situ in the SEER Manual, Behavior Code data item. |
2025 | |
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20250007 | Reportability/Behavior: Our registry collects some borderline (behavior /1) cases that are not reportable to SEER or any other standard setters. Can we assign a behavior code of /2 to these cases? |
Do not assign a behavior code of /2 to these cases unless you have a way to flag them so that they are not reported to the standard setters as in situ cases. Work with your state central registry to ensure that these cases are not unintentionally included in state case submission. |
2025 | |
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20250006 | Reportability/Histology--Appendix: Is carcinoid of the appendix reportable? If yes, when did this take effect? |
Report carcinoid, NOS of the appendix. As of 01/01/2015, the ICD-O-3 behavior code changed from /1 to /3. |
2025 | |
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20250009 | Sequence Number--Central/Reportability--Heme & Lymphoid Neoplasms: Is a hematolymphoid disease included in the sequencing if it was not reportable at the time of diagnosis? |
Do not include the disease in the sequencing if the original hematolymphoid disease was not reportable at time of diagnosis.
The 2025 SEER Manual Sequence Number--Central Coding Instruction 1.a advises: A ‘reportable’ primary refers to the site/histology/behavior of the tumor and the years when reporting was required. Review of the reportability requirements in effect during the diagnosis year will be needed. |
2025 | |
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20250015 | Solid Tumor Rules/Behavior--Brain and CNS: Why was the Behavior of solitary fibrous tumor (SFT)/hemangiopericytoma, WHO Grade 1 changed from /0 to /1 in the 2025 Solid Tumor Rules (STR) updates? See Discussion. |
In previous STR versions and the ICD-O-3.2, SFT/hemangiopericytoma, WHO G1 is 8815/0 and only SFT/hemangiopericytoma, WHO G2 was 8815/1. However, Table 6 (Non-Malignant CNS, Specific Histologies, NOS, and Subtypes/Variants) was changed in the 2025 updates to indicate both G1 and G2 SFT/hemangiopericytoma are 8815/1. No date range was provided for this change in the STR and the behavior of this tumor was not updated by the standard setters in other references (i.e., ICD-O-3.2). The behavior of G1 SFT/hemangiopericytoma was not updated in the 2025 ICD-O-3.2 updates. If the ICD-O-3.2 was the source of this change, should this have been documented in the 2025 NAACCR Implementation Guidelines? However, the 2025 NAACCR Implementation Guidelines indicates, "There are no ICD-O-3 changes for 2025." Is this behavior change in 2025 Solid Tumor Rules updates an error? Should the behavior of SFT/hemangiopericytoma, WHO G1 remain /0? |
For cases diagnosed 2025 and later: Assign behavior /1 for solitary fibrous tumor unless stated to be malignant. A review by the Cancer PathCHART expert neuropathologists found behavior code /0 is incorrect and both solitary fibrous tumor grade 1 and grade 2 are coded as 8815/1. WHO Classification of Central Nervous System Tumors, 5th edition, assigns behavior as /1 and no longer recommends terms solitary fibrous tumor/hemagiopericytoma and hemagiopericytoma. The STR table is correct. Future updates to ICD-O should reflect this behavior. WHO Classification of Tumours, Central Nervous System Tumours, 5th ed. was reviewed by the CPC expert pathologists for implementation for cases diagnosed January 1, 2025. Reminder: Comparing the CPC Validity Status included in the 2024 CPC*Search to that included in the 2025 SMVL (that table that drives the edits) is incorrect. CNS Tumors were not reviewed for 2024 implementation, they were reviewed for 2025 implementation. There will be a 2025 CPC*Search and a /1 will be designated as a Valid. |
2025 |
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20250016 | Reportability--Head & Neck: Are high-grade squamous dysplasia / “severe” squamous dysplasia or glandular intraepithelial neoplasia reportable for all Head & Neck subsites? If so, what year did they become reportable? In reviewing SINQ 20240003, 20230047, and 20230046, it appears that at least the larynx, mandible, and tongue have been reportable since 2021. However, 8077/2 and 8148/2 histology codes are not included in the Solid Tumor Rules (STRs) (2025 update) for Head and Neck, either in Tables 1-9 or the H Rules. |
High grade squamous dysplasia (8077/2) is reportable for head and neck sites for cases diagnosed as of 01/01/2021. High grade glandular intraepithelial neoplasia / glandular intraepithelial neoplasia grade III (8148/2) and high grade squamous intraepithelial neoplasia / squamous intraepithelial neoplasia grade III (8077/2) are reportable for head and neck sites for cases diagnosed as of 01/01/2001. Refer to other standard setters’ criteria for reportability as appropriate. |
2025 | |
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20250017 | SEER Manual/First Course Therapy--Neoadjuvant Therapy: How is Neoadjuvant Therapy--Treatment Effect coded for bladder cancers? The College of American Pathologists (CAP) Protocol for the Examination of Cystectomy Specimens From Patients With Carcinoma of the Urinary Bladder does not provide a clear distinction between the SEER site-specific codes for Neoadjuvant Therapy Treatment Effect for All Other Schemas, codes 2, 3, and 4, as compared to the CAP Treatment Effect Post Neoadjuvant Chemotherapy (BCG not included) categories. See Discussion. |
CAP Protocol for the Examination of Cystectomy Specimens From Patients With Carcinoma of the Urinary Bladder/Treatment Effect Post Neoadjuvant Chemotherapy (BCG not included) selections o No known presurgical neoadjuvant therapy o Complete response: Absence of histologically identifiable residual cancer cells and extensive fibrosis of the tumor bed after presurgical neoadjuvant therapy (TRG1) o Strong response: Predominant fibrosis of the tumor bed, with residual cancer cells occupying less than 50% of this area (TRG2) o Weak or no response: Residual cancer cells occupying ≥50% of the tumor bed or absence of regressive changes (TRG3) o Other (specify): _________________ SEER Coding Instruction for Site-Specific Codes for Neoadjuvant Therapy Treatment Effect - Schemas: All Other Schemas selections 0 Neoadjuvant therapy not given/no known presurgical therapy 1 Complete pathological response Present: No viable cancer cells/no residual invasive carcinoma identified Residual in situ carcinoma only 2 Near complete pathological response Present: Single cells or rare small groups of invasive cancer cells 3 Partial or minimal pathological response Present: Residual invasive cancer with evident tumor regression, but more than single cells or rare small groups of cancer cells 4 Poor or no pathological response Absent: Extensive residual cancer with no evident tumor regression 6 Neoadjuvant therapy completed and surgical resection performed, response not documented or unknown Cannot be determined 7 Neoadjuvant therapy completed and planned surgical resection not performed 9 Unknown if neoadjuvant therapy performed Unknown if planned surgical procedure performed after completion of neoadjuvant therapy
Death Certificate only (DCO) |
Code Neoadjuvant Therapy--Treatment Effect using the surgical pathology report only. Carefully review the pathology report gross description and comments to assist with assignment of codes. Review of neoadjuvant therapy data items is currently underway. |
2025 |
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20250014 | Race/Spanish Surname or Origin: How are Race 1 and Spanish Surname or Origin coded for the following race/ethnicity statements: "INDIGENOUS-LATINO/A OR INDIGENOUS-LATINX" and "FIRST NATIONS"? See Discussion. |
One of the largest hospital systems in our area includes "INDIGENOUS-LATINO/A OR INDIGENOUS-LATINX" and "FIRST NATIONS" as dropdown items for patients to self-select for race/ethnicity. This hospital system serves 51 hospitals and 1,000 clinics across Alaska, California, Montana, New Mexico, Oregon, Texas, and Washington. If "INDIGENOUS-LATINO/A OR INDIGENOUS-LATINX" is the only item selected with no additional text info available, how should Race 1 and Spanish Surname or Origin be coded? If "FIRST NATIONS" is the only item selected without additional text info available, should Race 1 be coded as 03? |
Assign code 01 (White) for Race 1 when described as Indigenous-Latino/a or Indigenous-Latinx. Indigenous-Latinx is an umbrella term for Indigenous migrants to the United States from Latin America including South and Central America, the Caribbean, and Mexico (for example, Maya, Mixteco, Purépecha, Taino, Zapoteco, etc.). Latin America is listed in Appendix D of the 2025 SEER Manual as White. Assign code 6 (Spanish, NOS; Hispanic, NOS; Latino, NOS) for Spanish Surname or Origin for Indigenous-Latino/a or Indigenous-Latinx in the absence of more specific information. Code 6 description includes the statement, There is evidence, other than surname or birth surname (maiden name), that the person is Hispanic but he/she cannot be assigned to any of the categories 1-5. Assign code 03 (American Indian or Alaska Native) when described as First Nations. First Nations usually refers to Indigenous peoples for ethnic groups who are the original or earliest known inhabitants of an area. The term ‘First Nations’ can be applied to individuals, but technically refers only to those who have Indian status under Canadian law as part of a recognized community. Within Canada, the term First Nations is generally used for Indigenous peoples other than Inuit and Métis. Outside Canada, the term can refer to Indigenous Australians, U.S. tribes within the Pacific Northwest, as well as supporters of the Cascadian independence movement. |
2025 |
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20250021 | Reportability--Heme & Lymphoid Neoplasms: Is a diagnosis of smoldering Waldenström macroglobulinemia (WM) reportable? See Discussion. |
The bone marrow was involved by lambda-restricted atypical B-cell and plasma cell populations with MYD88 mutation. Together these populations represent 10-15% of the bone marrow cellularity. While the bone marrow biopsy pathology alone did not provide a reportable diagnosis, the oncologist clinically diagnosed this as smoldering WM in the medical record. Is a diagnosis of smoldering WM similar to a diagnosis of smoldering multiple myeloma (MM), a reportable Heme neoplasm, since smoldering neoplasms may be considered to meet the neoplasm’s threshold in the bone marrow but is otherwise asymptomatic? |
Report smoldering WM (9761/3) using the Hematopoietic and Lymphoid Neoplasms Manual and Database (Table B9). Smoldering WM is defined as a poorly described asymptomatic disorder with a high risk of progressing to symptomatic WM requiring treatment. The term “smoldering” refers to the process meaning it is progressing, perhaps slowly, or even at a slower pace than might be expected. Smoldering WM resembles smoldering MM. |
2025 |
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20250011 | Reportability--Liver: Is a 2023 cholangiocarcinoma case with Liver Imaging Reporting And Data System (LI-RADS) M (LR-M) lesion on imaging reportable? |
Report LR-M unless there is information to the contrary. The American College of Radiology defines LR-M as "probably or definitely malignant, not necessarily hepatocellular carcinoma (HCC)." |
2025 |