HIM 233: Cancer Disease Coding and Staging

Course Description

This course is designed to provide an overview of cancer disease coding and staging. Students will be introduced to various cancer registry coding manuals and students will learn how and when to utilize each manual to assign primary site, histology and stage.

(3 credits)

Prerequisites

  • BIO 212: Anatomy and Physiology
  • BIO 215: Pathophysiology
  • HCA 105: Medical Terminology
  • HIM 230: Introduction to Cancer Registry and Management
  • HIM 231: Cancer Registry Operations

Student Learning Outcomes (SLOs)

Upon successful completion of the course, the student will be able to:

  1. Explain how to classify cancer topography (site) and morphology (histology).
  2. Differentiate how and when to utilize cancer registry manuals.
  3. Determine when a patient has more than one cancer.
  4. Explain what histology code to use when a patient has more than one histology.
  5. Apply knowledge to assign AJCC Stage, Tumor Grade, Extent of Disease, and Summary Stage.
  6. Describe the importance of cancer staging in treatment decisions and outcomes.
  7. Differentiate solid tumor cancers from hematopoietic cancers.
  8. Demonstrate how to apply coding rules to solid tumor cancers, hematopoietic cancers, and CNS tumors.

Course Activities and Grading

AssignmentsWeight

Discussions (Weeks 1-8)

25%

Quizzes (Weeks 1, 3, 4, 5, 6)

40%

Interactive Assignments (Week 2 & Week 7)

20%

Final Exam (Week 8)

15%

Total

100%

Required Textbooks

Available through Charter Oak State College's Book Bundle

  • National Cancer Registrars Association. Cancer Registry Management and Principles and Practice for Hospitals and Central Registries. 4th ed. NCRA, 2021. ISBN-13: 978-1-73291-783-5

  • Amin MB, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK, Gershenwald JE, Compton CC, Hess KR, et al. (Eds.). AJCC Cancer Staging Manual. 8th ed. Springer International Publishing: American Joint Commission on Cancer; 2017. ISBN-13: 978-3-319-40617-6

    Note: These textbooks are used in most of the Cancer Registry Management courses and should be saved for preparation for the CTR exam.

Course Schedule

Week

SLOs

Readings and Exercises

Assignments

1

1-4

Topics: Introduction to ICD-O-3 and Solid Tumor Rules (General Instructions)

  • Reading:
    • Read Chapter 8: ICD-O, Topography, Histology, and Solid Tumor Rules
    • Read the following sections in ICD-O-3:
      • 3. Structure and Format of ICD-O, third edition
      • 3.1 Abbreviations
      • 3.3 Topography – numerical list
      • 3.4 Morphology – numerical list
      • 3.5 Format of ICD-O terms in numerical list
      • 3.6 Alphabetic Index
      • 3.7 Format and use of alphabetic index
      • 3.10 Meaning of “NOS” (not otherwise specified) and how it is used
      • 3.11 Meaning of [OBS] (obsolete) and how it is used
      • 4.2.1 Topography Introduction
      • 4.2.6 Malignant neoplasm overlapping site boundaries
      • 4.3.1 Morphology Introduction
      • 4.3.2 Behavior
    • Read Solid Tumor Rules - General Instructions
  • Review course syllabus
  • Read assigned chapter
  • Read assigned materials
  • Review lecture material
  • Participate in discussions
  • Submit Week 1 Quiz - ICD-O-3 and Solid Tumor Rules General Instructions

2

1-4,8

Topic:  Solid Tumor Rules (Site Specific Breast and Lung)

  • Reading:
    • Review SEER Cancer Registry Site-Specific Modules:
      • Breast Cancer
      • Lung Cancer
    • Read Solid Tumor Rules Manual Site-Specific Rules (2022):
      • Breast Cancer
      • Lung Cancer
  • Read assigned materials
  • Participate in discussions
  • Submit Week 2 Interactive - Breast Solid Tumor Rules
  • Submit Week 2 Interactive - Lung Solid Tumor Rules

3

2,5,6

Topic: Introduction to Summary Stage and Extent of Disease

  • Reading:
    • Read the following sections in Chapter 9: Cancer Staging, Grade, and Site-Specific Data Items:
      • Summary Stage
      • Extent of Disease Coding
      • EOD 2018
    • Read Summary Stage - General Instructions
    • Review Summary Stage Manual
    • Read Extent of Disease - General Instructions
  • Read assigned chapter
  • Read assigned materials
  • Review lecture material
  • Participate in discussions
  • Submit Week 3 Quiz - Summary Stage and EOD

4

2,5,6

Topics: Introduction to Grade and Site-Specific Data Items

  • Readings:
    • Read the following sections in Chapter 9: Cancer Staging, Grade, and Site-Specific Data Items:
      • Grade
      • Site-Specific Data Items (SSDIs)
    • Read Grade Manual – General Instructions
  • Read assigned chapter
  • Read assigned materials
  • Review lecture material
  • Participate in discussions
  • Submit Week 4 Quiz - Grade and SSDI

5

2,5,6

Topics:  Introduction to AJCC Stage

  • Reading:
    • Read Chapter 9: Cancer Staging, Grade, and Site-Specific Data Items
    • Read the following section in AJCC Cancer Staging Manual:
      • Part 1: General Information on Cancer Staging and End-Results Reporting - Section 1: Principals of Cancer Staging
      • Note to Students: While it is highly recommended that students read the full contents of Part 1 of the AJCC Cancer Staging Manual, for this course, I am only assigning Section 1. I highly recommend that you review sections 2-4 (in Part 1) on your own time.
    • Read AJCC 8th Edition Staging - Introduction & Descriptors
    • View and listen to Cancer Staging PowerPoint Presentation
    • View the following in AJCC Curriculum for Registrars:
        • Module I: Introduction
        • Lesson 1: Why Staging Is Necessary and How Staging Is Used
        • Lesson 2: Purpose of Classifications and Their Use
        • Lesson 3: T, N, M Categories Used to Describe the Cancer Involvement
        • Lesson 4: Stage Groups Put Together Cases with Similar Prognosis
        • Lesson 5: Terminology—Difference Between Physician and Registrar
        • Lesson 6: What Is Cancer Staging
        • Lesson 7: Quiz
        • Module II: Beginning
        • Lesson 8: Classifications
        • Lesson 9: T Category
        • Lesson 10: N Category
        • Lesson 11: M Category
        • Lesson 12: Stage Group
        • Lesson 13: Staging for Multidisciplinary Health Care Team
        • Lesson 14: Quiz
      • Review SEER Training - American Joint Committee on Cancer
  • Read assigned chapter
  • Read assigned materials
  • Participate in discussions
  • Submit Week 5 Quiz - AJCC Cancer Staging

6

1,2,7,8

Topics: Introduction to Hematopoietic and Lymphoid Neoplasms

  • Readings:
    • Read the following sections in AJCC Cancer Staging Manual:
      • Introduction to Hematopoietic Neoplasms
      • Hodgkin and Non-Hodgkin Lymphoma
    • Read Hematopoietic and Lymphoid Neoplasm Coding Manual
      • Note to students: Review in full (start at Background and Introduction). You do not need to try to retain this information. Review the sections to try to know what is included so that when you are using this manual to abstract, you will be familiar with its contents.
    • Read Hematologic Malignancies: Summary Stage Manual
    • Review the following applicable sites on EOD Cancer Schema List:
      • HemeRetic
      • Lymphoma
      • Lymphoma Ocular Adnexa
      • Lymphoma-CLL/SLL
      • Mycosis Fungoides (MF)
      • Plasma Cell Disorders
      • Plasma Cell Myeloma
      • Primary Cutaneous Lymphoma (excluding MF)
    • Review SEER Cancer Registry Site-Specific Modules:
        • Lymphoma
        • Leukemia
    • Review Hematopoietic and Lymphoid Neoplasm Database
  • Read assigned chapter
  • Read assigned materials
  • Review lecture material
  • Participate in discussions
  • Submit Week 6 Quiz - Hematopoietic Malignancies

7

1-5,8

Topics: Introduction to Benign Brain Tumors

  • Readings:
    • Read the following sections in AJCC Cancer Staging Manual:
      • Brain
    • Read Solid Tumor Rules - Non-malignant CNS
    • Read Summary Stage - Brain
    • Read Grade Manual - Brain
    • Read EOD Schema List - Brain
    • Review SEER Cancer Registry Site-Specific Modules:
      • Brain & Other Nervous System Tumors
  • Read assigned chapter
  • Read assigned materials
  • Review lecture material
  • Participate in discussions
  • Submit Week 7 Interactive - Benign Brain Solid Tumor Rules
 8 1-8

Topic: Final Exam

  • Reading:

    • Review reading assignments and be familiar with where to find material in the various cancer registry manuals.

  • Review assigned chapters and assigned materials
  • Participate in discussions
  • Submit Week 8 Final Exam
  • Complete Course Evaluation

COSC Accessibility Statement

Charter Oak State College encourages students with disabilities, including non-visible disabilities such as chronic diseases, learning disabilities, head injury, attention deficit/hyperactive disorder, or psychiatric disabilities, to discuss appropriate accommodations with the Office of Accessibility Services at OAS@charteroak.edu.

COSC Policies, Course Policies, Academic Support Services and Resources

Students are responsible for knowing all Charter Oak State College (COSC) institutional policies, course-specific policies, procedures, and available academic support services and resources. Please see COSC Policies for COSC institutional policies, and see also specific policies related to this course. See COSC Resources for information regarding available academic support services and resources.