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Introduction
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The Surveillance,
Epidemiology and End Results (SEER)
Program of the National Cancer Institute collects cancer
data from designated populated-based cancer registries
in various areas of the country. There are two staging
classifications developed by SEER: extent of disease and
summary stage. Extent of disease (EOD) coding is required
for all SEER programs funded through the National Cancer
Institute.
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The Commission on Cancer (COC)
of the American College of Surgeons requires that the American
Joint Committee on Cancer (AJCC)
staging system be completed on all applicable sites and histologies.
The COC and NPCR
require summary staging on the sites or histologies not included
in AJCC staging.
Listed below are the staging systems to be discussed in this
learning unit:
General Guidelines for Staging all Schemes
- Stage grouping can only be applied to cancers that are
alike in site, histology, or both.
- Accurate and complete assessment of the cancer is necessary
before staging.
- Rule out distant disease first. When metastatic disease
is documented, there may be no need to look for information
about the primary tumor and regional lymph node status.
- A few cases are unstageable. The "unstageable" category
should be assigned only after all efforts to identify the
extent of the disease have been exhausted or the site or
histology does not meet criteria for staging.
- It is mandatory to stage uniformly using the same staging
classification in order to compare data or results.
- If staging information is unclear, it is important to
seek further information in order to ensure the quality
of data.
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