English French Notes Complete/Exclude A Add a new entry Select Enter/Edit Facility file Option: Enter 'E' to edit an existing FACILITY or 'A' to add a new FACILITY NEXT AVAILABLE LOCAL FIN NUMBER IS Do you want to add a new entry Identifies the facility that referred the patient to the reporting facility. Identifies the facility to which the patient was referred for care after discharge from the reporting facility. If you wish to add a new facility, enter either the 7-digit (6020009-6953290) or 8-digit (10000000+) assigned COC FIN If the new facility does not have an assigned COC FIN number, use the next available local FIN number. THE NEXT AVAILABLE LOCAL FIN NUMBER IS has no Primaries - cannot track Tumor Status : DATE DX MISSING for NO Tumor Status Followup Created DATE DX must precede DATE OF LAST CONTACT OR DEATH DATE OF LAST CONTACT OR DEATH must precede DATE@TIME OF DEATH Select Patient: ********* DISPLAY CONTACTS ********** Select Patient: ********** ADD/EDIT CONTACTS ********** Select Action Generate Letter...!! Complete Follow-up for Successful Contact!! **********Following fields have been updated******** Name..: DATA OK *********************ENTRY DELETED************************* Enter Patient name: ONCOLOGY PATIENT INQUIRY ********** Patient Follow-up Inquiry *********** Patient refers to this patient (him/herself) To Correct or edit name, edit 'Contact' in CONTACT File To CHANGE the name, Change CONTACT NAME above ************ PRINT FOLLOW-UP LETTER ************ You need to designate a contact before printing a letter! The letter is sent to 'LAST FOLLOW-UP CONTACT' You may enter a new contact if you wish: Select Patient: Contact or Contact Type is not defined Specify TYPE Contact letter: You may PRINT a hardcopy Choose one: No primaries for this Patient Enter your selection Print PCE data attached to this primary? Hit Enter to continue Print PCE's for a particular site Print PCE's AND Abstracts? Print PCE Data Enter the amount of alcohol consumed per day in whiskey equivalents Note-> One whiskey is equivalent to 10.24 grams of alcohol - 12 ounces of beer is equivalent to one whiskey - 4 ounces of wine is equivalent to one whiskey - 1 ounce of vodka, scotch, etc. is equivalent to one whiskey Enter the TOTAL amount of Radiation given Select from the following list: Common morpholgies for topography HISTOLOGY (ICD-O-3): Punctuation not allowed Lowercase text not allowed No nodes examined 97 or more nodes examined Nodes examined, # not specified Unknown if nodes examined, NA 90 or more nodes examined Node removal as sampling, # unknown Node removal as dissection, # unknown Nodes surgically removed, # unknown Unknown, NA or -, not stated All nodes negative 96 or more nodes positive Positive nodes, # not specified Unknown if nodes +, NA, not stated No radiation administered NA, brachytherapy/radioisotopes administered Dose unknown/unknown if administered Never consumed alcohol 97 or more drinks per week Yes, number of drinks unknown Not documented Test not administered Test administered but results unknown Not administered Administered, dose not documented Test not done Test done, results not documented Not documented if test performed Test not performed Test performed, not documented No transfusion performed Transfusion performed, units not documented Not recorded if transfusion done Never used tobacco No prior gastric resection No transfusion Transfusion, # of units not documented Not recorded if transfusion done No transfusion No free margins NA, no surgery of primary site Unknown, not documented Go to Date: JR. SR. MD. NMN. NMI. Choose from the following codes: 0 Not HIV positive 1 No known risk category 3 IV drug user 4 Blood product recipient 5 Heterosexual transmission 6 Congenitally acquired 7 Multiple categories 8 Other/Unknown risk category 9 Unknown if HIV positive Not HIV positive No known risk category Homosexual/Bisexual IV drug user Blood product recipient Heterosexual transmission Congenitally acquired Multiple categories Other/Unknown risk category Unknown if HIV positive Must be at least 3 characters Radiation before chemotherapy Chemotherapy before radiation Chemotherapy before and after radiation Radiation and chemotherapy concurrently Unknown if radiation and/or chemo given NA, no radiation and/or no chemo given Sequence unknown 1 Radiation before chemotherapy 2 Chemotherapy before radiation 3 Chemotherapy before and after radiation 4 Radiation and chemotherapy concurrently 7 Unknown if radiation and/or chemo given 8 NA, no radiation and/or no chemo given 9 Sequence unknown No satellite nodules 96 or more nodules Satellite nodules, # unknown NA, non-cutaneous melanoma No satellite nodules 96 or more nodules Satellite nodules, # unknown NA, non-cutaneous melanoma Cutaneous melanoma, thickness unk Primary site unknown Cutaneous melanoma, thickness unk Primary site unknown Margins free, distance unknown NA, surgery not performed mm or more Margins free, distance unknown NA, surgery not performed Sentinel Nodes Positive MUST be less than/equal Sentinel Nodes Examined! Number of Basins Positive MUST be less than/equal to Basins Detected! No nodes were examined 97 or more nodes examined Nodes examined, # not specified Unknown if nodes examined, NA No nodes examined 90 or more nodes examined No nodes removed, aspiration performed Node removal as sampling, # unknown Node removal as dissection, # unknown Nodes surgically removed, # unknown Unknown, NA or -, not stated All nodes negative 96 or more nodes positive Positive nodes, # not specified Unknown if nodes +, NA, not stated or higher No PSA test performed Test done, results unknown or not reported Unknown if test performed No, DCIS not present Yes, separate tumor Yes, mixed histology component Yes, separate tumor and mixed histology Yes, unk if separate tumor/mixed histology NA, reported tumor not invasive DC Unknown if DCIS present No, DCIS not present Yes, separate tumor Yes, mixed histology component Yes, separate tumor and mixed histology Yes, unk if separate tumor/mixed histology NA, reported tumor not invasive DC Unknown if DCIS present 0 No, DCIS not present 1 Yes, separate tumor 2 Yes, mixed histology component 3 Yes, separate tumor and mixed histology 4 Yes, unk if separate tumor/mixed histology 8 NA, reported tumor not invasive DC 9 Unknown if DCIS present Invasive DC reported, DCIS not present NA, invasive DC not reported Invasive DC reported, DCIS present, size unknown Invasive DC reported, unknown if DCIS present Invasive DC reported, DCIS not present NA, invasive DC not reported Invasive DC reported, DCIS present, size unknown Invasive DC reported, unknown if DCIS present No radiation given Radiation given, dose unknown Unknown if radiation given No radiation given Radiation given, dose unknown Unknown if radiation given No mass or no tumor found Microscopic focus, no size given Unknown; not stated; NA Melanoma > or = 9.89 mm in depth Use code 989 for melanomas > 9.89 mm in depth Too many decimal places 989 mm or larger No decimal point allowed Entire circumference Diffuse; widespread; linitis plastica Familial/multiple polyposis Diffuse, entire lobe of lung Diffuse; widespread; inflam carcinoma Code 998 may only be used with the following sites: No mass or no tumor found Microscopic focus, no size given Unknown; not stated; NA Melanoma > or = 9.89 mm in depth 989 mm or larger Entire circumference Diffuse; widespread; linitis plastica Familial/multiple polyposis Diffuse, entire lobe of lung Diffuse; widespread; inflam carcinoma Mucosal melanoma Unknown; not recorded; NA Mucosal melanoma Unknown; not recorded; NA Unknown, cannot be determined, not recorded Unknown, cannot be determined, not recorded No residual tumor Size not specified, tumor judged smaller Size not specified, tumor judged unchanged Size not specified, tumor judged larger NA, surgical treatment not administered Unknown, tumor not evaluated No residual tumor Size not specified, tumor judged smaller Size not specified, tumor judged unchanged Size not specified, tumor judged larger NA, surgical treatment not administered Unknown, tumor not evaluated Test not performed Test performed, not documented CANCER REGISTRY ABSTRACT Print Date: Patient Name: Home Address: Race: Ethnicity: Date of Birth: Age at DX: CANCER IDENTIFICATION Accession Number: Accession Year: Sequence Number: Date Dx: Dx Facility: Date of First Contact: Class of Case: Type of Reporting Source: Primary Site Code: Text-Primary Site Title: Text-Histology Title: AFIP Submission: Diagnostic Confirmation: Referring Facility: Transfer Facility: Presentation at Cancer Conf: Date of Cancer Conference: Print Complete Abstract Patient Name: EXTENT OF DISEASE AT DIAGNOSIS Clinical TNM: Pathologic TNM: Pathologic T: Pathologic N: Pathologic M: Clinical Stage Group: Pathologic Stage Group: Staged By (Clin): Staged By (Path): Lymphatic Vessel Invasion (L): #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### #################### ####################