Facility Oncology Registry Data Standards (FORDS): Revised for 2016

Eight new data items are introduced in FORDS: Revised for 2016 and required for cases diagnosed January 1, 2016 and later.

• Tumor Size Summary [756]
• Mets at Diagnosis - Distant Lymph Nodes [1114]
• Mets at Diagnosis – Bone [1112]
• Mets at Diagnosis – Brain [1113]
• Mets at Diagnosis – Liver [1115]
• Mets at Diagnosis – Lung [1116]
• Mets at Diagnosis – Other [1117]
• SEER Summary Stage 2000 [759]

Beginning with cases diagnosed in 2016, the following CS input data items are no longer required. They must continue to be abstracted for cases diagnosed from 2004 through 2015.

• CS Tumor Size [2800]
• CS Extension [2810]
• CS Tumor Size/Ext Eval [2820]
• CS Lymph Nodes [2830]
• CS Lymph Nodes Eval [2840]
• CS Mets at DX Data Items [2850-2854]
• CS Mets Eval [2860]
• CS Version Derived [2936]
• Derived AJCC-6 Data Items [2940-3000]
• Derived SS and Flag Data Items [3010-3050]
• Derived AJCC-7 Data Items [3400-3430]

The following data items were considered as CS input data items for the purposes of CS, but are now are continued to be required for AJCC staffing and research purposes. They are required for all cases diagnosed in 2004 and later:

• Regional Nodes Positive [820]
• Regional Nodes Examined [830]
• Lymph-vascular Invasion [1182]
• CS Site-specific Factors [2861-2880, 2890-2930]
• CS Version Input Original [2935]
• CS Version Input Current [2937]

Please note: The CoC’s requirements for the site-specific Factors have not changed from 2015; the data items of CS Version Input Original and Current continue to be required to accommodate continued collection of the SSFs.

Beginning in 2016, new T, N, and M categories were implemented by the AJCC T, N, and M data items [940, 950, 960, 880, 890, and 900]. These new categories have been generated by adding the prefixes of ‘c’ and ‘p’ to existing valid clinical and pathologic T, N, and M categories respectively, and modifying, adding and deleting specific categories. The new categories enable registrars to comply with AJCC clinical and pathologic staging/classification timeframe rules while abstracting. The new categories will be used for cases of all diagnosis years abstracted using NAACCR version 16-compliant (and later) software. Please note that not all possible categories were added in 2016, only those addressing prominent issues. Additional T, N, and M categories will be added and use of existing categories will be expanded with the implementation of the AJCC 8th Edition Manual. This implementation will allow registrars to comply with AJCC rules while abstracting, thus reducing stage assignment confusion and increasing registrar confidence in assigning AJCC stage, increasing data integrity, and reducing the time and resources that registrars and standard setters currently spend addressing these issues.

The CoC will require CoC-accredited cancer programs to use the new T, N, and M categories and convert historical data upon upgrading to NAACCR version 16-compliant software (Please see the NAACCR 2016 Implementation Guidelines for complete details). Conversion of historical data for the diagnosis years of 2015 and earlier is being carried out for the purposes of formatting the data to accommodate consistent viewing, abstraction, and editing of the data across all diagnosis years. Please note that the prefixes included in the new categories are only intended to reflect clinical significance for cases diagnosed January 1, 2016 and later, and should not be analyzed in any fashion for cases diagnosed Existing T, N, and M values will not be converted for any cases diagnosed in 2016 that are initially abstracted using NAACCR Version 15-compliant software. As a result, the T, N, and M categories will need to be reviewed for these cases upon upgrade to NAACCR Version 16-compliant software. The registrar will have to accurately re-assign the new T, N, and M categories (that include c and p designations).

Beginning with cases diagnosed January 1, 2016 and later, both clinical and pathologic AJCC stage will be required for data submission to the NCDB. The requirement will be enforced via edits. CS is no longer required (required historically for cases diagnosed from 2004–2015).

For cases diagnosed 2016 and later, no software-derived values should be submitted in the directly-assigned AJCC Stage data items [910, 970]. Registrars are encouraged to fully understand how their vendor software functions, and should never manually copy over any derived values into the directly-assigned data items. Algorithms are under development to identify derived values submitted in the directly-assigned data items. Programs will receive a deficiency on CoC Program Standard 5.6 if submission of derived values in the directly-assigned AJCC Stage data items is detected.

The hospital registrar will be responsible for recording the physician-assigned stage in the registry database.

• If the stage assigned by the physician is inconsistent with the documentation in the medical record, the registrar should assign the stage and record the registrar-assigned stage in the registry database. The registrar should verify the case information with the physician, as he or she may have additional information that would aid in the assignment of a stage. However, it is outside the realm of the responsibility of the registrar to educate the physician. The registrar should inform the registry physician advisor and refer identified coding issues to the Cancer Committee for quality improvement activities.
• If no physician-assigned stage can be found in the medical record, the registrar should assign the stage and record it in the registry database. The registrar should inform the registry physician advisor and refer identified documentation issues to the Cancer Committee for quality improvement activities.
• CoC Program Standard 1.10, Clinical Educational Activity states that the required cancer-related educational activity offered to physicians, nurses, and other allied health professionals is to be focused on the use of AJCC (or other appropriate) staging. The cancer committee is encouraged to use AJCC-developed materials for this purpose.

The length of the TNM Path Staged By [930] and TNM Clin Staged By [990] data items has been expanded to 2 digits to accommodate new codes. The historic 1 character codes will be concerted to the new codes upon upgrade to NAACCR Version 16-compliant software.

All items in FORDS are required for CoC-accredited cancer programs. Supplementary references are necessary for coding American Joint Committee on Cancer, Collaborative Stage, multiple primaries and histologies, hematopoietic tumors, and systemic agents.

Documents posted on this page are for informational purposes only. For current documentation, see NCDB Data Submission.

Facility Oncology Registry Data Standards (FORDS): Revised for 2016

Facility Oncology Registry Data Standards (FORDS): Revised for 2015
This edition introduced revised Rules for Coding Grade/Differentiation and new natal sex codes for transsexuals.

Facility Oncology Registry Data Standards (FORDS): Revised for 2013
This edition was the first to introduce Country data items and to add Secondary Diagnosis items 1-10.

Facility Oncology Registry Data Standards (FORDS): Revised for 2012
This edition of FORDS introduced new instructions for coding Scope of Regional Lymph Node Surgery based on the surgical notes. It also introduced instructions for coding Grade/Differentiation when the CS special grade items Grade Path System, Grade Path Value, or CS Site-Specific Factor store grade information. It was in use during 2012.

Facility Oncology Registry Data Standards (FORDS): Revised for 2011
This edition of FORDS was the first to include new code ranges for ICD-10-CM comorbidities and complications. It was in use during 2011.

Facility Oncology Registry Data Standards (FORDS): Revised for 2010 (updated May 2010)
This edition of FORDS includes the new collaborative stage (CS) items for CS v2, new date transmission formats, and a number of new and converted data items.

Facility Oncology Registry Data Standards (FORDS): Revised for 2009
This edition of FORDS introduced the changes to staging rules introduced during 2008, clarifications for coding embolization, and revised rules for coding in utero diagnosis and treatment dates.

Facility Oncology Registry Data Standards (FORDS): Revised for 2007 (updated April 2007)

Facility Oncology Registry Data Standards (FORDS): Revised for 2004 (published September 2005)
This document includes the 2004 manual plus updated/revised material for use in 2006.

Facility Oncology Registry Data Standards (FORDS): Revised for 2004
The Revised for 2004 edition includes the completely revised 2004 manual, which included all revisions dated from 2002 through September 2004.

Facility Oncology Registry Data Standards (FORDS) (published in 2002)
The original FORDS manual includes the complete 2002 manual with updates posted through March 2003.

Registry Operations and Data Standards (ROADS)
Codes and coding rules used from 1996 through 2002.