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Introduction to the Tennessee Cancer Registry for Cancer Care Abstractors

Module 5: Class of Cases


This module consists of three units which provide basic information related to class of case.

After completing this module, cancer abstractors will be able to:

Class of Case

The class of case divides cases recorded in the database of the facility into categories of analytic and non-analytic. Analytic data includes cases diagnosed at the accessioning facility and/or administration of any of the first course of treatment after the *registry’s reference date. Non-analytic cases are first diagnosed and receive all of first course of therapy at another institution, or are diagnosed at autopsy or by death certificate only. Non-analytic cases are not usually included in routine treatment or survival statistics. Based on category, the cancer program can select cases to be used by their facility or to be reported to the central registry, as well as, the National Cancer Data Base (NCDB).

*Definition for the reference date of the cancer registry:
The start date when a cancer registry is established is known as the reference date. It should be set as January 1, of a given year. Once this date is established, all cases diagnosed and/or treated at a facility on or after this date must be entered into the registry. For example: If a facility has established a cancer registry by beginning reporting for 2005 cases, the reference date would be established as January 1, 2005.


Module 5 Units:

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Unit 5.1: Analytic Cases

General Guidelines

Class 0
Diagnosis at accessioning facility and the entire first course of treatment was performed elsewhere or the decision not to treat was made at another facility.

Class 1
Diagnosis at the accessioning facility, and all or part of the first course of treatment was performed at the accessioning facility.

Class 2
Diagnosis elsewhere, and all or part of the first course of treatment was performed at the accessioning facility.

Unit 5.2: Non-Analytic Cases

Class 3
Diagnosis and all of first course treatment elsewhere.

Class 4
Diagnosis and/or first course of treatment was performed at the accessioning facility prior to the reference date* of the registry.

Class 5
Diagnosed at autopsy.

Class 6
Diagnosed and the entire first course of treatment completed by a staff physician in the office setting. “Staff physician” refers to any medical staff with admitting privileges at the accessioning facility.

Class 7
Pathology report only. The patient does not enter the reporting facility at any time for diagnosis or treatment. This category excludes cases diagnosed at autopsy.

Class 8*
Diagnosis established only by death certificate.

Class 9*
Unknown

*NOTE: Codes 8 and 9 are used in central registries only.

Reportable analytic cases class 0 and class 1 must be abstracted and submitted to the central registry within six months of diagnosis. Reportable analytic case class 2, in addition to, non-analytic cases class 3 and 4 must be abstracted and submitted within six months of the first contact for treatment to the central registry.

Unit 5.3: Class of Case Codes and Descriptions

Codes

Description

0

First diagnosed at the reporting institution, since the registry’s reference date, and all of first course of therapy elsewhere.

1

First diagnosed and all or part of the first course of therapy was performed at the reporting institution.

2

First diagnosed elsewhere and treatment plan developed and documented and/or the first course of therapy given at the reporting institution, after the registry’s reference date.

3

First diagnosed and the entire first course of therapy elsewhere.

4

First diagnosed and/or first course of therapy at the reporting institution before the reference date of the registry.

5

First diagnosed at autopsy.

6

Diagnosed and the entire first course of treatment by staff physician in an office setting. “Staff physician” is any medical staff with admitting privileges at the reporting facility.

7

Pathology report only (excludes cases diagnosed at autopsy).

8

Diagnosis established only by death certificate.*

9

Unknown.*

*Note: Codes 8 and 9 are used in central registries only

Module 5 Review and Quiz

The start date when a cancer registry is established is known as the reference date. It should be set as January 1, of a given year. Once this date is established, all cases diagnosed and/or treated at a facility on or after this date must be entered into the registry.

Class of case divides cases into analytic and non-analytic.

Class of Case codes 0-2 are analytic (i.e. the patient was diagnosed and/or received all or part of first course of treatment or had treatment planning at the reporting hospital).

Class of case codes 3-5 and 7- 9 are non-analytic (i.e. the patient was first diagnosed and received all of first course of therapy at another institution, or was diagnosed at autopsy or by death certificate only).

Class 0 - Diagnosis at accessioning facility and the entire first course of treatment was performed elsewhere or the decision not to treat was made at another facility.

Class 1 - Diagnosis at the accessioning facility, and all or part of the first course of treatment was performed at the accessioning facility.

Class 2 - Diagnosis elsewhere, and all or part of the first course of treatment was performed at the accessioning facility.

Class 3 – Diagnosis and all of first course treatment elsewhere.

Class 4 - Diagnosis and/or first course of treatment was performed at the accessioning facility prior to the reference date of the registry.

Class 5 - Diagnosed at autopsy.

Class 6 - Diagnosed and the entire first course of treatment completed by a staff physician in the office setting. “Staff physician” refers to any medical staff with admitting privileges at the accessioning facility.

Class 7 - Pathology report only. The patient does not enter the reporting facility at any time for diagnosis or treatment. This category excludes cases diagnosed at autopsy.

Class 8 - Diagnosis established only by death certificate.

Class 9 - Unknown

*Note: Codes 8 and 9 are used in central registries only

Quiz for Module 5

Click here to take the  Module 5 Quiz.