CTR Practice Test

The Certified Tumor Registrar (CTR) exam is for candidates pursuing certification in cancer registry work through eligible education or experience routes. This page brings together free topic practice sets, worked explanations, and verified exam details to help you plan your preparation. Practice Test Geeks uses AI tools to write content. These are our practice questions, not real exam questions; check rules and requirements against the official material.

CTR Exam at a Glance

What changed for CTR in 2026

• Oct 25, 2026: Delivery changed to Meazure Learning test center or remote online testing (previously Meazure Learning test center or live remote proctoring).^[4]
• Oct 25, 2026: Renewal changed to 20 CE every 2 years + annual fee; due Jan 31 (previously 20 CE every 2 years + 8 CEIP every 4 years + annual fee; due Jan 31).^[3]
• Oct 25, 2026: Testing window (Fall 2026) changed to Oct 23 – Nov 14, 2026 (previously October 23 – November 14, 2026).^[1]
• Oct 25, 2026: Exam fee changed to $435 ($335 NCRA members) (previously $435 ($335 for NCRA members)).^[2]
• Oct 25, 2026: Time limit changed to 4 hours (2 h closed-book + 2 h open-book, 15-minute break) (previously 4 hours (2 h closed-book + 2 h open-book, plus a 15-minute break)).^[1]
• Oct 25, 2026: Passing score changed to Criterion-referenced cut score (Modified-Angoff), combined total (previously Criterion-referenced cut score (Modified-Angoff); combined total score).^[1]
• Oct 25, 2026: Score release changed to About 6–8 weeks after the exam window (previously About 6–8 weeks after the testing window).^[1]
• Oct 25, 2026: Eligibility changed to Route 1/2: NCRA-accredited program + practicum; Route 3: 1,950 hours registry experience + associate degree incl. A&P (previously Route 1/2: NCRA-accredited program + practicum; Route 3: 1,950 hours of registry experience + associate degree (60 credits) incl. A&P).^[1]

What the CTR is and how it works

According to National Cancer Registrars Association (NCRA), Council on Certification, “The cut score or passing point used in this examination is determined by a criterion-referenced approach called the Modified-Angoff method.”^[1]

The certification exam is administered through the National Cancer Registrars Association (NCRA), Council on Certification. Candidates can test at a Meazure Learning assessment center or use remote online testing. The exam allows 4 hours of answering time: 2 hours closed-book and 2 hours open-book, with a 15-minute break.

Eligibility depends on your route. Routes 1 and 2 require an NCRA-accredited program and a practicum. Route 3 requires 1,950 hours of cancer registry experience plus an associate degree that includes anatomy and physiology. Use NCRA’s official candidate handbook to check the requirements for your route before applying.

The passing point uses a criterion-referenced method called Modified-Angoff. The result is based on the combined total; the supplied facts do not establish a fixed passing percentage. Scores are available about 6–8 weeks after the exam window, so plan around the window’s end rather than your appointment date.

You may take the exam only once per testing window. A retake requires a new application for a later window. Consult NCRA’s Certification Exam page for application dates and its candidate handbook for exam rules. The practice topics below are site categories; no verified official content-area outline was supplied for mapping them to the exam.

Worked examples: how to reason through CTR questions

These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.

Example 1

Question: Which U.S. national program collects population-based cancer incidence and survival data from registries across the country?

1. SEER (Surveillance, Epidemiology, and End Results)
2. NCDB (National Cancer Database)
3. CoC (Commission on Cancer)
4. NPCR (National Program of Cancer Registries)

Answer: A. SEER (Surveillance, Epidemiology, and End Results)

Explanation:

A, SEER, is the intended answer. NCI describes SEER as collecting cancer incidence and survival data from population-based registries. See the [SEER overview](https://seer.cancer.gov/about/overview.html). B, NCDB, uses hospital registry data, as explained by the [American College of Surgeons](https://www.facs.org/quality-programs/cancer-programs/national-cancer-database/). C, CoC, refers to the Commission on Cancer associated with accredited cancer programs, rather than the named surveillance program. D needs a caveat: NPCR also supports population-based incidence and survival statistics, according to [CDC](https://www.cdc.gov/united-states-cancer-statistics/dataviz/index.html). It cannot be dismissed cleanly under this wording. Remember to distinguish programs by their sponsoring organization and data sources. Specifying NCI in the question would make SEER the clear answer.

Example 2

Question: What does 'resection margin status' (R classification) describe in surgical pathology reports?

1. Depth of tumor invasion into the wall
2. Presence of residual tumor after surgical resection
3. Number of lymph nodes removed
4. Lymphovascular invasion status

Answer: B. Presence of residual tumor after surgical resection

Explanation:

B is correct because R classification describes whether tumor remains after treatment, including surgical resection. The [AJCC staging principles](https://www.facs.org/media/xuxfkbpb/principles_cancer_staging.pdf) distinguish residual tumor status from the anatomical extent of cancer. A describes how deeply the tumor invades tissue, which does not by itself establish whether tumor remains after surgery. C describes the quantity of lymph nodes removed, not residual disease. D concerns tumor involvement of lymphatic or blood vessels, which is also a separate finding. Remember to ask what the report statement measures: remaining tumor, invasion depth, lymph node removal, or lymphovascular invasion. Margin findings inform residual tumor assessment, but these terms should not be treated as interchangeable.

Example 3

Question: Under CoC standards, what is the maximum number of days from date of first contact at a facility to the date a case must be abstracted?

1. 6 months
2. 3 months
3. 1 year
4. 30 days

Answer: A. 6 months

Explanation:

A, 6 months, is the supplied answer key, but this item needs source verification before you use it to learn a reporting deadline. The stem asks for days while the keyed answer uses months. The supplied verified facts do not establish this CoC requirement or support the standard cited in the existing explanation. B, 3 months, and D, 30 days, describe shorter intervals than the keyed answer; C, 1 year, describes a longer interval. Those differences explain the intended choice, but do not establish the current rule. For deadline questions, verify the applicable standard, case category, starting event, and time unit before memorizing an answer.

How to use these practice tests

Start with the NCRA candidate handbook. Check your eligibility route, read the testing rules, and identify the reference materials permitted for your exam. Keep the official material available when reviewing practice explanations.

Use CTR Casefinding and CTR Cancer Registry Data Collection to examine how you identify reportable information. Then work through CTR Abstracting & Coding and CTR Staging & Prognostic Factors. Choose topics according to your errors; these categories do not establish official exam weighting.

For each missed question, record the clue you overlooked, the rule you applied, and the source that resolves the answer. Separate recall mistakes from difficulty locating a rule. Revisit uncertain explanations before repeating the set, especially questions that assert a reporting deadline.

Practise closed-book recall separately from looking up answers in permitted references. Use CTR Data Quality & Completeness to review checking decisions. Before test day, confirm your appointment instructions and review the handbook’s requirements for your chosen delivery method.

Sources & last verified

1. National Cancer Registrars Association (NCRA), Council on Certification — time limit, passing score, retake policy, eligibility (official source). “Candidates have four (4) hours to complete the examination. You will have two (2) hours to complete the closed-book section and two (2) hours to…” Verified Oct 25, 2026.
2. National Cancer Registrars Association (NCRA), Council on Certification — exam fee, registration deadline, testing window (official source). “NCRA member rate: $335; non-member rate: $435.” Verified Oct 25, 2026.
3. National Cancer Registrars Association (NCRA), Council on Certification — renewal (official source). “ODS-certified professionals must complete 20 hours of continuing education (CE) credits every two years” Verified Oct 25, 2026.
4. National Cancer Registrars Association (NCRA), Council on Certification — delivery (official source). “The exam is offered at in-person assessment centers and by remote testing” Verified Oct 25, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.