Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 186 - HEALTH REGISTRIES AND RELEASE OF INFORMATION › Chapter 1 - CANCER REGISTRY › Attachment 186-1-1 - DATA ITEMS REQUIRED BY THE NEBRASKA CANCER REGISTRY FROM CANCER REPORTING SOURCES

Current through June 17, 2024
ltem#
Item Name
70
Address at Diaqnosis-City
80
Address at Diagnosis-State
90
County at Diagnosis
100
Address at Diagnosis-Postal Code
150
Marital Status at Diagnosis
160
Race 1
161
Race 2
162
Race 3
163
Race 4
164
Race 5
170
Race Coding System-Current
180
Race Coding System-Original
190
Spanish/Hispanic Origin
220
Sex
230
Age at Diagnosis
240
Birth Date
250
Birthplace
260
Religion*
310
Text-Usual Occupation*
320
Text-Usual Industry*
340
Tobacco History*
350
Alcohol History*
360
Family History of Cancer*
390
Date of Diagnosis
400
Primary Site
410
Laterality
419
Morphology-Type & Behavior ICD-
				0-2H
420
Histology ( 92-00) ICD-
				0-2H
430
Behavior ( 92-00) ICD-
				0-2H
440
Grade
450
Site Coding System-Current
460
Site Coding System-Original
470
Morphology Coding System-Current
480
Morphology Coding System-Original
490
Diagnostic Confirmation
500
Type of Reporting Source
521
Morphology-Type & Behavior ICD-O-3
523
Behavior Code ICD-O-3
540
Reporting Hospital
550
Accession Number-Hospital
560
Seguence Number-Hospital
570
Abstracted By
580
Date of 1st Contact
610
Class of Case
620
Year First Seen This Cancer*
630
Primary Payer at Diagnosis
670
Treatment Hospital-Surgery Primary Site
672
Treatment Hospital-Scope Regional Lymph Node Surgery
674
Treatment Hospital-Surgery Other Regional/Distant
700
Treatment Hospital-Chemotherapy
710
Treatment Hospital-Hormone Therapy
720
Treatment Hospital-lmmunotherapv
730
Treatment Hospital-Other
740
Treatment Hospital-Diagnosis/Staging Procedure
759
SEER Summary Stage 2000
760
SEER Summary Stage 1977H
780
Extent of disease-Tumor Size
820
Regional Nodes Positive
830
Regional Nodes Examined
880
TNM Pathologic Tumor
890
TNM Pathologic Nodes
900
TNM Pathologic Metastases
910
TNM Pathologic Stage Group
920
TNM Pathologic Descriptor
930
TNM Pathologic Staged By
940
TNM Clinical Tumor
950
TNM Clinical Nodes
960
TNM Clinical Metastases
970
TNM Clinical Stage Group
980
TNM Clinical Descriptor
990
TNM Clinical Staged By
1060
TNM Edition Number
1150
Tumor Marker 1*
1160
Tumor Marker 2*
1170
Tumor Marker 3*
1200
Treatment Date-Surgery
1210
Treatment Date-Radiation
1250
Treatment Date-Other
1270
Date of 1st Course of
				Treatment-COC
1280
Treatment Date-Diagnosis/Staging Procedure
1290
Treatment Summary-Surgery Primary Site
1292
Treatment Summary-Scope Regional Lymph Nodes Surgery
1294
Treatment Summary-Surgery Other Regional/Distant
1320
Treatment Summary-Surgical Margins
1340
Reason for No Surgery
1350
Treatment Summarv-Diagnosis/Staging Procedure
1380
Treatment Summarv-Surgerv/Radiation Seguence
1390
Treatment Summary-Chemotherapy
1400
Treatment Summary-Hormone Therapy
1410
Treatment Summarv-lmmunotherapv
1420
Treatment Summary-Other
1430
Reason for No Radiation Therapy
1460
Treatment Coding System-Current
1510
Radiation-Regional Dose: cGy
1520
Radiation-Number of Treatment Volume
1540
Radiation-Treatment Volume
1550
Radiation-Location of Treatment
1570
Radiation-Regional Treatment Modality
1660
Subseguent Treatment 2nd Course
				Date*
1670
Subseguent Treatment 2nd Course
				Codes*
1671
Subseguent Treatment 2nd Course
				Surgery*
1672
Subseguent Treatment 2nd Course
				Radiation*
1673
Subseguent Treatment 2nd Course
				Chemotherapy*
1674
Subseguent Treatment 2nd Course
				Hormone Therapy*
1675
Subseguent Treatment 2nd Course
				Immunotherapy*
1676
Subseguent Treatment 2nd Course
				Other*
1677
Subseguent Treatment 2nd-Scope Lymph
				Nodes Surgery*
1678
Subseguent Treatment 2nd-Surgery
				Other*
1679
Subseguent Treatment 2nd-Regional
				Lymph Nodes Removed*
1680
Subsequent Treatment 3rd Course
				Date*
1690
Subsequent Treatment 3rd Course
				Codes*
1691
Subsequent Treatment 3rd Course
				Surqery*
1692
Subsequent Treatment 3rd Course
				Radiation*
1693
Subsequent Treatment 3rd Course
				Chemotherapy*
1694
Subsequent Treatment 3rd Course
				Hormone Therapy*
1695
Subsequent Treatment 3rd Course
				Immunotherapy*
1696
Subsequent Treatment 3rd Course
				Other*
1697
Subsequent Treatment 3rd-Scope Lymph
				Nodes Surqery*
1698
Subsequent Treatment 3rd-Surqerv
				Other*
1699
Subsequent Treatment 3rd-Reqional
				Lymph Nodes Removed*
1700
Subsequent Treatment 4th Course
				Date*
1710
Subsequent Treatment 4th Course
				Codes*
1711
Subsequent Treatment 4th Course
				Surqery*
1712
Subsequent Treatment 4th Course
				Radiation*
1713
Subsequent Treatment 4th Course
				Chemotherapy*
1714
Subsequent Treatment 4th Course
				Hormone Therapy*
1715
Subsequent Treatment 4th Course
				Immunotherapy*
1716
Subsequent Treatment 4th Course
				Other*
1717
Subsequent Treatment 4th-Scope Lymph
				Nodes Surqery*
1718
Subsequent Treatment 4th-Surqerv
				Other*
1719
Subsequent Treatment 4th-Reqional
				Lymph Nodes Removed
1720
Subsequent Treatment 5th Course
				Date
1730
Subsequent Treatment 5th Course
				Codes
1731
Subsequent Treatment 5th Course
				Surqery*
1732
Subsequent Treatment 5th Course
				Radiation*
1733
Subsequent Treatment 5th Course
				Chemotherapy*
1734
Subsequent Treatment 5th Course
				Hormone Therapy*
1735
Subsequent Treatment 5th Course
				Immunotherapy*
1736
Subsequent Treatment 5th Course
				Other*
1737
Subsequent Treatment 5th-Scope Lymph
				Nodes Surqery*
1738
Subsequent Treatment 5th-Surqerv
				Other*
1739
Subsequent Treatment 5th-Reqional
				Lymph Nodes Removed*
1750
Date of Last Contact
1760
Vital Status
1770
Cancer Status
1790
Follow-Up Source
1800
Next Follow-Up Source
1810
Address Current-City
1820
Address Current-State
1830
Address Current-Postal Code
1860
Recurrence Date-1st
1880
Recurrence Type-1st
1930
Autopsy*
1940
Place of Death*
1980
ICD-O-2 Conversion Flaq
1985
Over-ride Accession/Class of Case/Sequence
1986
Over-ride Hospital Sequence/Diaqnostic Confirmation
1987
Over-ride COC-Site/Type
1988
Over-ride Hospital Sequence/Site
1989
Over-ride Site/TNM-Staqinq Group
1990
Over-ride Aqe/Site/Morpholoqy
2020
Over-ride Surqery/Diaqnostic Confirmation
2030
Over-ride Site/Type
2040
Over-ride Histoloqy
2070
Over-ride Leukemia Lymphoma
2071
Over-ride Site/Behavior
2074
Over-ride Site/Laterality/Morphology
2110
Date Case Report Exported
2111
Date Case Report Received
2112
Date Case Report Loaded
2113
Date Tumor Record Available
2116
ICD-O-3 Conversion Flaq
2140
COC Coding System-Current
2150
COC Coding System-Original
2170
Vendor Name
2230
Name-Last
2240
Name-First
2250
Name-Middle
2270
Name-Suffix
2280
Name-Alias
2290
Name-Spouse/Parent*
2300
Medical Record Number
2310
Military Record No Suffix
2320
Social Security Number
2330
Address at Diagnosis-Number & Street
2335
Address at Diagnosis-Supplemental
2350
Address Current-Number & Street
2355
Address Current-Supplemental
2360
Telephone
2390
Name-Maiden*
2410
Institution Referred From
2420
Institution Referred To
2440
Following Registry
2460
Physician-Managing
2470
Phvsician-Follow-Up
2480
Physician-Primary Surgery
2490
Physician 3
2500
Physician 4
2520
Text-Diagnosis Procedure-Physical Exam
2530
Text-Diagnosis Procedure-X-ray/scan
2540
Text-Diagnosis Procedure-Scopes
2550
Text-Diagnosis Procedure-Lab Tests
2560
Text-Diagnosis Procedure-Operative
2570
Text-Diagnosis Procedure-Pathology
2580
Text-Primary Site Title
2590
Text-Histology Title
2600
Text-Staging
2610
Treatment Text-Surgery
2620
Treatment Text-Radiation (Beam)
2630
Treatment Text-Radiation Other
2640
Treatment Text-Chemotherapy
2650
Treatment Text-Hormone Therapy
2660
Treatment Text-lmmunotherapv
2670
Treatment Text-Other
2680
Text-Remarks
2690
Place of Diagnosis
2800
Collaborative Stage Tumor Size*
2810
Collaborative Stage Extension*
2820
Collaborative Stage Tumor Size/Extension Evaluation*
2830
Collaborative Stage Lymph Nodes*
2840
Collaborative Stage Regional Lymph Nodes Evaluation*
2850
Collaborative Stage Metastasis at Diagnosis*
2880
Collaborative Stage Site-Specific Factor 1*
2890
Collaborative Staqe Site-Specific Factor 2*
2900
Collaborative Stage Site-Specific Factor 3*
2910
Collaborative Staqe Site-Specific Factor 4*
2920
Collaborative Staqe Site-Specific Factor 5*
2930
Collaborative Staqe Site-Specific Factor 6*
2940
Derived AJCC Tumor*
2950
Derived AJCC Tumor Descriptor*
2960
Derived AJCC Lymph Nodes*
2970
Derived AJCC Lymph Nodes Descriptor*
2980
Derived AJCC Metastasis*
2990
Derived AJCC Metastasis Descriptor*
3000
Derived AJCC Staqe Group*
3010
Derived Summary Staqe (SEER)1977*
3020
Derived Summary Staqe 2000*
3030
Derived AJCC-Conversion Flaq*
3040
Derived Summary Staqe 1977-Conversion Flaq*
3050
Derived Summary Staqe 2000-Conversion Flaq
3100
Archive Federal Identification Number
3110
Comorbidities/Complication 1
3120
Comorbidities/Complication 2
3130
Comorbidities/Complication 3
3140
Comorbidities/Complication 4
3150
Comorbidities/Complication 5
3160
Comorbidities/Complication 6
3170
Treatment Date-Most Definitive Surqerv
3180
Treatment Date-Surqical Discharqe
3190
Readmission Same Hospital within 30 Days
3200
Radiation-Boost Treatment Modality
3210
Radiation-Boost Dose cGy
3220
Treatment Date-Radiation Ended
3230
Treatment Date-Systemic
3250
Treatment Summarv-Transplant/Endocrine Procedures
3270
Treatment Summary-Palliative Procedure
3280
Treatment Hospital-Palliative Procedure
Codes for Recommendations:
*- Required when
				available. H - Historically collected and currently transmitted.