California Cancer Registry Volume I: Data Standards and Data Dictionary
Cancer Reporting in California: Abstracting and Coding Procedures for Hospitals
Source: DSQC #2000-06 Clarification: Focus, Focal and Foci, 03/08/00
Question: Does the term focal mean the same thing as focus and foci when coding tumor size?
Answer: No. Focus and foci are microscopic descriptions and are coded 001 when no other information is available. Focal refers to an area of involvement, focal should be coded 999.
The SEER Inquiry System Question and Answer #75 (4/94) states focus, focal and foci are variations of the same word. At the 5/99 SEER Coder and Abstractor Workshop, an answer was given which stated that focal does not equal focus and foci. Focal refers to an area of involvement. According to Carol Johnson, SEER, the 5/99 workshop response takes precedence over the SINQ question. It is a newer interpretation based on actual usage of the words in pathology reports.
Below are some examples of diagnoses from pathology reports followed by the correct tumor size.
1) focal adenocarcinoma - TS 999
2) microfocus of adenocarcinoma - TS 001
3) multiple foci of adenocarcinoma in specimen - TS 001
4) multifocal adenocarcinoma in specimen - TS 999
5) microscopic focus of adenocarcinoma in multiple fragements - TS 001
6) focal adenocarcinoma in chips - TS 999
7) focal adenocarcinoma in 5% of specimen - TS 999