California Cancer Reporting System Standards Volume I: Abstracting and Coding Procedures for Hospitals
The CCR has adopted the SEER policy for reporting whether lesions are single or multiple primaries. The policy states:
The determination of how many primary cancers a patient has is, of course, a medical decision, but operational rules are needed in order to ensure consistency of reporting by all participants. Basic factors include the site of origin, the date of diagnosis, the histologic type, the behavior of the neoplasm (i.e., in situ vs. malignant), and laterality. In some neoplasms, one must be careful since different histologic terms are used to describe progressive stages or phases of the same disease process.
Therefore, for purposes of statewide reporting, the following operational rules take precedence over the physician's determination of the number of primaries. Refer to Section V.1.2 for the rules for determining site.
Beginning with cases and tumors diagnosed January 1, 2007 forward, the CCR requires the use of the 2007 Multiple Primary and Histology Coding Rules Manual. The 2007 Multiple Primary and Histology rules replace all previous multiple primary rules except those for hematopoietic neoplasms.
The rules are effective for cases diagnosed on or after January 1, 2007. Do not use these rules to abstract cases diagnosed prior to January 1, 2007.
If there is a previously diagnosed cancer primary before January 1, 2007, do not change the previous primary based on the new rules. Use the new rules for any new tumor diagnosed after January 1, 2007, to determine if it is an additional primary. Refer to the SEER Multiple Primary and Histology Coding Rules Manual for specific instructions.
Note: Use the 2007 Multiple Primary and Histology rules to determine the number of primaries to be abstracted. Do not use the Multiple Primary and Histology Rules to determine reportability, stage or to assign grade.
For cases diagnosed January 1, 2005 through December 31, 2006, apply the SEER Multiple Primary and Histology Rules as written in the SEER Program Coding and Staging Manual, 2004.
For cases diagnosed prior to January 1, 2005, refer to Section II.1.3.1.