CCR Innovations | Volume 2 | Issue 1 - page 5

California Cancer Registry
Volume 2, Issue 1
Obesity-Linked Cancers: A California Status Report, 1988-2009
Obesity’s impacts on health are far reaching and can include such chronic conditions as coronary heart
disease, type 2 diabetes, hypertension and certain types of cancer. This report focuses on obesity in
California and specifically highlights the incidence and mortality rates of the types of cancer that have
been linked to obesity and how these rates have changed since 1988.
The report can be accessed at the following link:
SINQ, is a collection of questions reported by CTRs related to how to code
cancer cases. This resource can be used in addition to the CCR Inquiry System when you come across
abstracting questions. To help bring together all of the different resources available to CTRs, each
month the CCR will be reviewing new questions submitted to SINQ and providing summaries of
relevant questions and answers here. We will also provide direct links to the discussed question for
your convenience. This section will help make sure registrars across the state are aware of any updates
that may affect their daily work efforts.
For Lung cases, is Lepidic a new term for histology?
The term Lepidic will be addressed in the 2015 revision of SEER’s Multiple Primary and
Histology Rules. Lepidic" is a growth pattern meaning that tumor cells are growing along the alveolar
septa. It is characteristic of bronchioloalveolar carcinoma (BAC), but not diagnostic of it; the diagnosis
of BAC also requires no stromal, vascular, or pleural invasion. Lepidic growth may be seen in other
adenocarcinomas, including metastases to lung from other sites. It is not considered a type/subtype of
adenocarcinoma. For lepidic lung neoplasms, code the histology indicated, for example BAC.
Grade rules state to code the grade from the primary tumor only, never from a metastatic
site or a recurrence. If the primary tumor extends into a structure and that structure was biopsied and
graded, can that grade be used? Is this considered part of the primary tumor, or does it have to be the
primary organ/structure?
: For one tumor involving a contiguous site, when there is no tissue specimen available from
the primary site, you may code the grade based on the tissue from the tumor in the contiguous site.
This instruction is included in SEER’s
under Coding for Solid
Tumors – Rule 2a.
Resources: SEER Inquiry System
Sara N. Cook, MPH, CHES
Health Educator IV
California Cancer Reporting and Epidemiologic Surveillance (CalCARES) Program
Institute for Population Health Improvement
UC Davis Health System
1,2,3,4 6,7,8,9,10,11,12,13,14