CCR Innovations | Volume 2 | Issue 1 - page 6

California Cancer Registry
Volume 3, Issue 1
U.S. that report data to Surveillance, Epidemiology, and End Results (SEER) Program. Geographic locaƟon of 
residence at diagnosis is reported to SEER.  Current address is not. This ensures comparability of naƟonal 
cancer incidence rates that are reported by the NaƟonal Cancer InsƟtute (NCI). 
Rules for recording address instruct the cancer registrar to enter the address of the paƟent’s
Usual 
Residence
on the date of the iniƟal diagnosis.  
Usual Residence
 is defined as the place where the paƟent 
lives and sleeps most of the Ɵme and is not necessarily the same as the legal or voƟng residence. 
In a discussion about residence at diagnosis, it is important to note that a post office box is not a reliable 
source to idenƟfy the residency at diagnosis.  Post office box addresses do not provide accurate 
geographical informaƟon for analyzing cancer incidence.  Use the post office box address ONLY if no street 
address informaƟon is available aŌer follow‐back.  
Determining a paƟent’s residence at the Ɵme of diagnosis can be challenging in our transient society.  Folks 
are conƟnuously on the move. PaƟents diagnosed with a serious illness may move to another area aŌer 
diagnosis to be closer to relaƟves, or friends for support.  In order to accurately record the address at the 
Ɵme of iniƟal diagnosis, the abstractor should review the clinical history informaƟon in the medical record.  
This is because the face sheet may, or may not reflect the residence at diagnosis. It may reflect a new post‐
diagnosis address. 
Another challenge facing cancer registrars in California is the number of large referral hospitals offering 
state‐of‐the‐art care.   Cancer paƟents from around the world flock to areas that are known to provide high 
quality or innovaƟve care.  Some paƟents stay with friends, or relaƟves as they consult with cancer experts. 
Some paƟents take up temporary residence in a region for extended cancer treatment protocols.  The new 
and/or temporary address they provide is not to be recorded as the address at the Ɵme of iniƟal diagnosis. 
At the Ɵme of cancer case abstracƟon, the cancer registrar should be alert to indicators that may suggest 
that the address on the face sheet does not reflect the paƟent’s address at the Ɵme of iniƟal diagnosis.  
Some quesƟons the abstractor should be asking are: 

Was the paƟent diagnosed in a different geographical area?  If so, why? 

Does the paƟent usually live in a different geographical area? 

Is the paƟent here for consultaƟon or treatment only? 

Has the pathology department been asked to review slides from a hospital located in another 
state? 
The answers to these quesƟons must be viewed with cauƟon. The answers may indicate an out‐of‐area 
residence at the Ɵme of diagnosis. However, the answers may also idenƟfy residents of your region who 
were diagnosed while they were away from their usual residence.   
If complete informaƟon on address at diagnosis is not available, enter as much informaƟon into the 
Address at Diagnosis field as is known.  For example, the abstractor is able to ascertain only that the paƟent 
was a resident of Nevada at the Ɵme of diagnosis.  State is recorded as Nevada while street address, zip 
code and county are recorded as “unknown.” 
(Cont. Pg 7)
1,2,3,4,5 7,8,9,10,11,12,13,14,15