CTR Casefinding 2 — Questions and Answers
Question 1: Which department is considered a SECONDARY source for casefinding in a hospital-based cancer registry?
- Pathology
- Radiology
- Surgery
- Emergency Department (Correct answer)
Correct answer: Emergency Department
Emergency departments are secondary sources because cancer diagnoses are rarely made there; pathology, radiology, and surgery are primary sources.
Question 2: A tumor registrar reviews the operating room log and finds a procedure coded as 'excision of lesion, breast.' What is the next casefinding step?
- Abstract the case immediately
- Request the pathology report to confirm malignancy (Correct answer)
- Check the radiology report only
- Wait for physician dictation
Correct answer: Request the pathology report to confirm malignancy
The pathology report must be reviewed to confirm whether the lesion is malignant before abstracting a case.
Question 3: Which of the following would NOT be reportable to a hospital cancer registry under standard ACOS CoC guidelines?
- In situ carcinoma of the cervix diagnosed and treated at the facility
- Basal cell carcinoma of the skin diagnosed at the facility (Correct answer)
- Metastatic colon cancer first diagnosed at the facility
- Recurrent breast cancer treated at the facility
Correct answer: Basal cell carcinoma of the skin diagnosed at the facility
Basal cell carcinoma of the skin is generally excluded from cancer registry reporting under ACOS CoC guidelines.
Question 4: A patient is diagnosed with lung cancer at an outside facility and comes to your hospital only for a second opinion with no treatment rendered. How should this case be handled?
- Abstract as an analytic case
- Abstract as a non-analytic case (Correct answer)
- Do not abstract; the case is not reportable
- Abstract only if the physician documents agreement with diagnosis
Correct answer: Abstract as a non-analytic case
A case diagnosed elsewhere where only a second opinion (consultation) is provided without treatment is abstracted as a non-analytic case.
Question 5: When performing casefinding, a registrar discovers a death certificate listing 'carcinoma of the pancreas' with no prior hospital record. What action is required?
- Ignore it since there is no hospital record
- Create a death certificate only (DCO) case (Correct answer)
- Contact the physician to obtain treatment records
- Report to the state registry only
Correct answer: Create a death certificate only (DCO) case
A death certificate only (DCO) case is created when the death certificate is the sole source of cancer information and no prior medical records can be obtained.
Question 6: Which type of ambulatory surgery center report is MOST useful for casefinding?
- Anesthesia pre-op assessments
- Procedure logs with pathology results (Correct answer)
- Billing encounter forms only
- Nursing care plans
Correct answer: Procedure logs with pathology results
Procedure logs paired with pathology results identify surgical cases with confirmed malignancy, making them the most productive casefinding source in ambulatory settings.
Question 7: A registrar finds a patient treated for 'malignant neoplasm, colon' in the pharmacy system with chemotherapy drugs dispensed. No existing registry record exists. What should the registrar do?
- Abstract based on the pharmacy record alone
- Investigate further using medical records to confirm and abstract (Correct answer)
- Ignore pharmacy records as they are not valid casefinding sources
- Flag for future review only
Correct answer: Investigate further using medical records to confirm and abstract
Pharmacy records are useful leads for casefinding but the complete medical record must be reviewed to confirm diagnosis and abstract accurately.
CTR Casefinding 2
Which department is considered a SECONDARY source for casefinding in a hospital-based cancer registry?