California Cancer Reporting System Standards Volume I: Abstracting and Coding Procedures for Hospitals
The term "in situ" means a tumor that meets all microscopic criteria for malignancy, except invasion of basement membrane. For further discussion of "in situ", see Section V.5.1.
"In situ" behavior can be determined only by pathologic examination and not by clinical evidence alone. If a tumor is classifiable as "in situ" according to the time period rules for stage at diagnosis see Section V.5, code the tumor as "in situ". In other words, a behavior code of 2, "in situ", corresponds to a stage code of 0, "in situ" and vice versa. Computer and visual edits will verify that the codes in these two fields correspond. Do not interpret terms like "approaching in situ" or "very close to in situ" as "in situ".
Reportable terms indicating "in situ" behavior include:
AIN III (anal intraepithelial neoplasia)**
Behavior code ‘2’
Bowen's Disease (not reportable for C440-C449)
DCIS (ductal carcinoma in situ)
DIN 3 (ductal intraepithelial neoplasia 3)**
Clark's level 1 for melanoma (limited to epithelium)
Confined to epithelium
Hutchinson's melanotic freckle, NOS (C44_)
Intracystic, non-infiltrating (carcinoma, only)
Intraductal (carcinoma, only)
Intraepidermal, NOS (carcinoma, only)
Intraepithelial, NOS (carcinoma, only)
Intrasquamous
Involvement up to but not including the basement membrane
LCIS (lobular carcinoma in situ)
Lentigo maligna (C44_)
LIN III (laryngeal intraepithelial neoplasia)**
Lobular neoplasia, Grade III
Lobular, noninfiltrating (C50_)(carcinoma, only)
No stromal invasion/involvement
Non-infiltrating (carcinoma, only)
Noninvasive (carcinoma, only)
PanIN-III (pancreatic intraepithelial neoplasia III)***
Papillary, noninfiltrating or intraductal (carcinoma, only)
PeIN III (penile intreaepithelial neoplasia III (C60_))**
Precancerous melanosis (C44_)
Preinvasive
Queyrat's erythroplasia (C60_)
SIN III (squamous intraepithelial neoplasia)****
Stage 0 (except Paget’s disease (8540/3) of breast and colon or rectal tumors confined to the lamina propria)
VAIN III (vaginal intraepithelial neoplasia)(C529)*
VIN III (vulvar intraepithelial neoplasia)(C51_)*
* Effective with cases diagnosed 01/01/1992 and later.
** Effective with cases diagnosed 01/01/2001 and later.
***Cases diagnosed 01/01/2004 and later.
****Cases diagnosed 01/01/2014 and later.
All other terms have been reportable since the region’s reference date.
As a reminder, carcinoma "in situ" (including squamous cell and adenocarcinoma) of the cervix and Cervical Intraepithelial Neoplasia, CIN III, are not reportable effective with cases diagnosed January 1, 1996 and later.
Prostatic Intraepithelial Neoplasia (PIN III), morphology code 8148/2 is also not reportable to the CCR.
Beginning with cases diagnosed January 1, 2012 forward, AIN II-III, VIN II-III, and VAIN II-III are no longer reportable.