Download:
pdf |
pdf
ATTACHMENT 3a
MDE Data Items and Definitions Required for Reporting
OMB Control No. 0920‐0571
Expiration Date: 10/31/2015
DATA USER'S MANUAL
for the
National Breast and Cervical Cancer
Early Detection Program (NBCCEDP)
MDE Version 6.0
Effective Date 01/01/2009
Division of Cancer Prevention and Control
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
Public reporting burden of this collection of information is estimated to average 4 hours per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a
person is not required to respond to a collection of information unless it displays a currently valid OMB control
number. Send comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE,
MS D‐24, Atlanta, Georgia 30333; ATTN: PRA (0920‐0571).
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Table of Contents:
Section 1
Screening Location .................................................................................................................................. 2-152
Section 2
Patient and Record Identification ............................................................................................................. 2-152
Section 3
Patient Demographic Information ............................................................................................................. 2-153
Section 4
CBE Screening Information ...................................................................................................................... 2-154
Section 5
Pap Test Screening Information ............................................................................................................... 2-155
Section 6
Initial Mammography Information ............................................................................................................. 2-161
Section 7
Cervical Diagnostic Procedures ............................................................................................................... 2-166
Section 8
Cervical Diagnosis Information................................................................................................................. 2-167
Section 9
Cervical Cancer Treatment Information ................................................................................................... 2-168
Section 10
Breast Imaging Procedures ...................................................................................................................... 2-169
Section 11
Breast Diagnostic Procedures .................................................................................................................. 2-170
Section 12
Breast Final Diagnosis Information .......................................................................................................... 2-171
Section 13
Breast Cancer Treatment Information ...................................................................................................... 2-173
Section 14
Cervical Cancer Registry Data ................................................................................................................. 2-174
Section 15
Breast Cancer Registry Data.................................................................................................................... 2-178
MDE Version 6.0
09/2008
2-151
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Column
Old
Variable Name
Length
Begin
End
Codes / Format / Comments
Edit Checks/Skip Patterns
All Patients Section: This section must be completed for each MDE record when NBCCEDP funds are used to pay for all or part of at least one of the screening or diagnostic procedure(s).
1. Screening Location
1.01
1a
State, Territorial, or Tribal
Program
2
1
2
FIPS Code, Right Justify (i.e. California = 6 and Texas = 48,
where = a blank character.
Valid code for your program.
1.02
1b
County
3
3
5
FIPS Code, Right Justify.
Valid codes for your program.
This is the county of the primary B&C provider.
1.03
1d
Enrollment Site
5
6
10
Right Justify. This should be the point of enrollment of the woman Valid codes for your sites.
to the program. The intent is to identify the center that is
administratively responsible for the care and tracking of the
woman.
15
11
25
If Social Security Number (SSN) is used, it must be encoded. The
ID number should be unique and constant for each patient in order
to track the patient over time. This field should not contain any
identifiable information, including partial names or dates.
2. Patient and Record Identification
2.01
2a
Unique Patient ID Number
Alphanumeric (no special symbols), left justify.
Alphabetic characters must be entered consistently in
uppercase or lowercase for all records for each patient.
2.02
2b
Record Identifier
8
26
33
Right Justify. This field will be used to uniquely identify one
record among many for a woman. This could be a cycle number, a
visit date, or a record number. In this context, record and
screening cycle have the same meaning.
MDE Version 6.0
09/2008
2-152
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
Column
Variable Name
Length
Begin
End
Codes / Format / Comments
Edit Checks/Skip Patterns
3. Patient Demographic Information
3.01
3a
County of Residence
3
34
36
FIPS Code, Right Justify. (If unknown, blank fill.) Not required if
Zip Code of residence is reported.
Valid FIPS code for the county.
3.02
3b
State or Territory of
Residence
2
37
38
FIPS Code, Right Justify. (If unknown, blank fill.)
Valid FIPS code for the state or territory.
3.03
3c
ZIP Code of Residence
5
39
43
Right Justify. (If unknown, blank fill) Not required if county of
residence is reported.
Valid 5 digit numeric zip code.
3.04
3d
Date of Birth
8
44
51
MMDDYYYY (i.e. Jan 3, 1942 = 01031942). If unknown, blank fill. Check for validity, i.e. no one too old or too young at date
of enrollment. See edit guidelines for dates at the end of
this document.
3.05
3f
Hispanic or Latino Origin
(self reported)
1
52
52
1. Yes
2. No
3. Unknown
Range check.
3.06. 1
3g.1
Race 1
(self reported)
1
53
53
1. White
2. Black or African American
3. Asian
4. Native Hawaiian or Other Pacific Islander
5. American Indian or Alaska Native
7. Unknown
8. Asian/Pacific Islander (v4.1 only)*
Range check. This race field should be populated first. If a
woman self identifies more than one race, then each race
identified should be reported in a separate race field.
Report up to five (5) separate races.
1. White
2. Black or African American
3. Asian
4. Native Hawaiian or Other Pacific Islander
5. American Indian or Alaska Native
7. Unknown
This field should be left blank, unless the woman reports
more than one race.
It is recommended that your Program no longer collect
„Other‟ race on your data collection forms. However, if your
Program collects ‟Other„ as a race category, please export
*8 - Asian/Pacific Islander (v4.1 only) may only be reported for data this to ‟7‟ (Unknown) in the MDEs.
collected prior to 10/01/2002.
3.06.2
3g.2
Race 2
(self reported)
1
54
54
MDE Version 6.0
09/2008
2-153
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
Column
New
Old
Variable Name
Length
Begin
End
Codes / Format / Comments
Edit Checks/Skip Patterns
3.06.3
3g.3
Race 3
(self reported)
1
55
55
1. White
2. Black or African American
3. Asian
4. Native Hawaiian or Other Pacific Islander
5. American Indian or Alaska Native
7. Unknown
This field should be left blank, unless the woman reports
more than two races.
3.06.4
3g.4
Race 4
(self reported)
1
56
56
1. White
2. Black or African American
3. Asian
4. Native Hawaiian or Other Pacific Islander
5. American Indian or Alaska Native
7. Unknown
This field should be left blank, unless the woman reports
more than three races.
3.06.5
3g.5
Race 5
(self reported)
1
57
57
1. White
2. Black or African American
3. Asian
4. Native Hawaiian or Other Pacific Islander
5. American Indian or Alaska Native
7. Unknown
This field should be left blank, unless the woman reports
more than four races.
4. CBE Screening Information
4.01
4c
Breast Symptoms
(self reported)
1
58
58
1. Yes
2. No
3. Unknown
Range check.
4.02
4d
Clinical Breast Exam
1
59
59
1. Normal/Benign findings - schedule for routine CBE in
one year
2. Abnormality suspicious for cancer - diagnostic evaluation
needed
3. Not needed
4. Needed but not performed at this visit (includes refused)
Range check.
If "Clinical Breast Exam" = „1‟ or „2‟, enter MMDDYYYY
If not blank, must be a valid date. Check the skip pattern.
See edit guidelines for skip patterns at the end of this
document.
4.03
4e
Date of Clinical Breast Exam
8
60
67
If "Clinical Breast Exam" = „3‟ or „4‟, blank fill.
If the result of this clinical breast exam is „2‟, the Additional
Breast Procedures Section should be completed and
"Additional Procedures Needed to Complete Breast Cycle"
(6.08) should be „1‟. Reference Model Clinical Guidelines
in MDE Data User's Manual, Section 2.
MDE Version 6.0
09/2008
2-154
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
Column
New
Old
Variable Name
Length
Begin
End
4.04
4e.1
Clinical Breast Exam Paid by
NBCCEDP Funds
1
68
68
Codes / Format / Comments
1. Yes
2. No
3. Unknown
If ”Clinical Breast Exam” = „3‟ or „4‟, blank fill.
Edit Checks/Skip Patterns
Range and skip pattern check.
If office visit (which includes Clinical Breast Exam) was
paid by NBCCEDP funds, then this field should be set to
„1‟.
5. Pap Test Screening Information
5.01
4f
Previous Pap Test
1
69
69
1. Yes
2. No
3. Unknown
Range check.
5.02
4f.1
Date of Previous Pap Test
6
70
75
If "Previous Pap Test" = „1‟ then enter MMYYYY (if known) or blank If not blank, must be a valid date. Check the skip pattern.
fill (if unknown).
If "Previous Pap Test" = „2‟ or „3‟, blank fill.
MDE Version 6.0
09/2008
2-155
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
5.03
Column
Variable Name
Length
Begin
End
Indication for Pap Test
1
76
76
Codes / Format / Comments
1. Routine Pap test
2. Patient under surveillance for a previous abnormal test.
3. Pap test done by a non-program funded provider, patient
referred in for diagnostic evaluation.
4. Pap test not done. Patient proceeded directly for diagnostic
work-up or HPV test.
5. Breast record only, cervical services not done.
9. Unknown
Edit Checks/Skip Patterns
Range and skip pattern check.
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
„1‟ (Routine) should be reported for a Pap test performed
as part of a routine screening schedule. Items 5.05 – 5.16
should be reported as appropriate. Item 5.04 should be
blank.
„2‟ (Surveillance) should be reported for a Pap test
performed on a woman under management for a cervical
abnormality detected prior to this cycle. Items 5.05 – 5.16
should be reported as appropriate. Item 5.04 should be
blank.
„3‟ (Referred) should be reported when a patient has had a
Pap test performed outside of the Program, and is referred
to the Program for diagnostic work-up. Referral Date (5.04)
must be completed, and a valid Pap test Result should be
provided: (5.08) “Bethesda 1991” = 1-8, 12 or 14; or (5.09)
“Bethesda 2001” = 1-8 or 12.
„4‟ (Not Done) should be reported when the patient does
not have a Pap test and goes directly to HPV testing or
Diagnostic Work-up. Items 5.04 – 5.12 should be blank.
„5‟ (Breast record only) should be reported when no
cervical services are provided or reported in this record,
only breast services. Items 5.04 – 5.16 should be blank.
MDE Version 6.0
09/2008
2-156
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
5.04
Column
Variable Name
Length
Begin
End
Cervical Diagnostic Referral
Date
8
77
84
Codes / Format / Comments
If “Indication for Pap Test” = “3”, enter MMDDYYYY; otherwise
leave blank
Edit Checks/Skip Patterns
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
If not blank, must be a valid date. Check the skip pattern.
See edit guidelines for skip patterns at the end of this
document.
This field should indicate the enrollment date for a patient
referred in to the program for diagnostic evaluation
following an abnormal Pap test provided outside of the
program.
5.05
4g
Bethesda System Used
1
85
85
1. Bethesda 1991
2. Bethesda 2001
Range check.
This field should indicate which Bethesda System was
used to report the Pap test result. If system used is „1',
then “Bethesda ‟91 Pap test Result” (5.08) should be
completed. If system used is ‟2', then “Bethesda ‟01 Pap
test Result” (5.09) should be completed.
This field should be left blank if “Indication for Pap Test”
(5.03) is „4‟ or „5‟.
MDE Version 6.0
09/2008
2-157
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
Column
New
Old
Variable Name
Length
Begin
End
5.06
4g.1
Specimen Adequacy of Pap
Test
1
86
86
(For both 1991 and 2001
Bethesda Systems)
Codes / Format / Comments
1. Satisfactory
2. Satisfactory for evaluation but limited by... (for Bethesda
1991 results only)
3. Unsatisfactory
4. Unknown
Edit Checks/Skip Patterns
Range check.
This field should be left blank if “Indication for Pap Test”
(5.03) is „4‟ or „5‟.
For data where Pap test was done prior to 10/01/2002, this
field may be blank. For Pap tests performed after
10/01/2002, this field MUST be completed.
If “Bethesda System Used” (5.05) is ‟1' and Specimen
Adequacy is „1‟, „2‟ or „4‟ then “Bethesda ‟91 Pap test
Result” (5.08) must be completed. If Specimen Adequacy
is ‟3', then “Bethesda ‟91 Pap test Result” (5.08) must be „8‟
(Unsatisfactory).
If “Bethesda System Used” (5.05) is ‟2' and Specimen
Adequacy is „1‟ or „4‟, then” Bethesda ‟01 Pap test Result”
(5.09) must be completed. If Specimen Adequacy is ‟3',
then “Bethesda ‟01 Pap test Result” (5.09) must be left
blank. A specimen adequacy result of ‟2' is NOT VALID for
Bethesda 2001.
5.07
4g.3
Specimen Type for
Pap Test
1
87
87
1. Conventional smear
2. Liquid Based
3. Other
4. Unknown
Range check.
This field should be left blank if “Indication for Pap Test”
(5.03) is „4‟ or „5‟.
MDE Version 6.0
09/2008
2-158
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
Column
New
Old
Variable Name
Length
Begin
End
5.08
4g.2
Result of Pap Test
2
88
89
Categories from the
Bethesda 1991 Reporting
System
5.09
4g.4
Result of Pap Test
2
90
Categories from the
Bethesda 2001 Reporting
System
5.10
4g.5
Other Pap Test Result
20
92
91
Codes / Format / Comments
Edit Checks/Skip Patterns
Right Justify
1. Negative (within normal limits)
2. Infection/Inflammation/Reactive Changes
3. Atypical squamous cells of undetermined significance
(ASCUS)
4. Low grade SIL (including HPV changes)
5. High grade SIL
6. Squamous Cell Cancer
7. Other
8. Unsatisfactory
11. Result pending
12. Result unknown, presumed abnormal, Pap test from nonprogram funded source
14. Abnormal Glandular Cells (including Atypical Glandular
Cells of Undetermined Significance (AGUS) and
Adenocarcinoma)
Range check.
Right Justify
1. Negative for intraepithelial lesion or malignancy
2. Atypical squamous cells of undetermined significance
(ASC-US)
3. Low grade SIL (including HPV changes)
4. Atypical squamous cells cannot exclude HSIL (ASC-H)
5. High grade SIL
6. Squamous Cell Carcinoma
7. Abnormal Glandular Cells (including Atypical,
Endocervical adenocarcinoma in situ and adenocarcinoma)
8. Other
11. Result pending
12. Result unknown, presumed abnormal, Pap test from nonprogram funded source.
Range check.
This field should be left blank if “Bethesda System Used”
(5.05) is ‟2'.
This field should be left blank if “Indication for Pap Test”
(5.03) is „4‟ or „5‟.
If the result of this screening Pap test is a „5‟, „6‟, „12‟, or
„14‟ the Additional Cervical Procedures Section MUST be
completed and "Diagnostic work-up planned for cervical
dysplasia or cancer“ (5.16) set to „1‟. If the result is a „3‟ or
„4‟ and the clinician chooses to do a diagnostic work-up, the
Additional Cervical Procedures Section MUST also be
completed and "Diagnostic work-up planned for cervical
dysplasia or cancer" (5.16) set to „1‟.
This field should be left blank if “Bethesda System Used”
(5.05) is ‟1'.
This field should be left blank if “Indication for Pap Test”
(5.03) is „4‟ or „5‟.
If the result of this Pap test is a „4‟, ‟5‟, „6‟, „7‟, or „12‟ the
Additional Cervical Procedures Section MUST be
completed and "Diagnostic work-up planned for cervical
dysplasia or cancer“ (5.16) set to „1‟. If the result is a „1‟, „2‟
or „3‟ and the clinician chooses to do a diagnostic work-up,
the Additional Cervical Procedures Section MUST also be
completed and "Diagnostic work-up planned for cervical
dysplasia or cancer" (5.16) set to „1‟.
111 If "Result of Pap Test" = „7‟ from the 1991 Bethesda, or „8‟ from the Check the skip pattern.
2001 Bethesda, enter "Result" in free text format.
This field should be left blank if “Indication for Pap Test”
(5.03) is „4‟ or „5‟.
MDE Version 6.0
09/2008
2-159
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
Column
New
Old
Variable Name
Length
Begin
End
Codes / Format / Comments
5.11
4h
Date of Pap Test
8
112
119 For Bethesda 1991:
If "Result of Pap Test" ≤ „8‟ or „14‟, enter MMDDYYYY.
If you know the date for „11‟ or „12‟, enter MMDDYYYY, otherwise
blank fill.
Edit Checks/Skip Patterns
If not blank, must be a valid date and > “Date of Previous
Pap test” (5.02), if known. Check the skip pattern.
This field should be left blank if “Indication for Pap Test”
(5.03) is „4‟ or „5‟.
For Bethesda 2001:
If "Result of Pap Test" ≤ „8‟, enter MMDDYYYY.
If you know the date for „11‟ or „12‟, enter MMDDYYYY, otherwise
blank fill.
5.12
4i
Pap Test Paid by NBCCEDP
Funds
1
120
120 1. Yes
2. No
3. Unknown
If ”Result of Pap Test“ = „11‟, and paid data are known, then
enter „1‟ or '2‟. Otherwise blank fill.
If ”Result of Pap Test“ = „12‟, this field should be set to „2‟.
5.13
HPV Test Result
1
121
121 1. Positive
2. Negative
3. Test Not Done
9. Unknown
Range and skip pattern check.
If the Pap test, laboratory services, or pelvic exam were
paid by NBCCEDP funds, then this field should be set to „1‟
(Yes).
This field should be left blank if “Indication for Pap Test”
(5.03) is „4‟ or „5‟.
Range check.
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
This field should be left blank if “Indication for Pap Test”
(5.03) is „5‟.
5.14
Date of HPV Test
8
122
129 If “HPV Test Result” = „1‟, „2‟ or „9‟, then enter MMDDYYYY
If “HPV Test Result” = „3‟, blank fill.
Date of HPV Test is the date of the sample collection.
If not blank, must be a valid date. Check the skip pattern.
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
This field should be left blank if “Indication for Pap Test”
(5.03) is „5‟.
MDE Version 6.0
09/2008
2-160
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
5.15
Column
Variable Name
Length
Begin
End
Codes / Format / Comments
HPV Test Paid by NBCCEDP
Funds
1
130
130 1. Yes
2. No
3. Unknown
Complete this field if “HPV Test Result” = „1‟, „2‟, or „9‟.
If “HPV Test Result” = „3‟, blank fill.
5.16
4g.6
Diagnostic Work-up Planned
for Cervical Dysplasia or
Cancer
1
131
131 1. Diagnostic work-up planned on basis of abnormal Pap test
or pelvic exam
2. Diagnostic work-up not planned
3. Diagnostic work-up plan not yet determined
Edit Checks/Skip Patterns
Range and skip pattern check.
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
This field should be left blank if “Indication for Pap Test”
(5.03) is „5‟.
If “Indication for Pap Test” (5.03) is „1‟, „2‟, „3‟, „4‟, or „9‟ this
field must be completed; otherwise, leave blank.
.
The purpose of this field is to indicate the need for
immediate diagnostic work-up. In the vast majority of cases
an abnormal Pap test (defined in 5.08 or 5.09) or pelvic
exam (not collected) will indicate that a diagnostic work-up
is necessary. However, in a small number of cases a
diagnostic work-up will be performed in the absence of an
abnormal Pap test or pelvic exam.
If this field is coded as „1‟, the Additional Cervical
Procedures Section must be completed. If this field is
coded as „2‟ or „3‟, the Additional Cervical Procedures
Section must be blank.
6. Initial Mammography Information
6.01
4j
Previous Mammogram
1
132
132 1. Yes
2. No
3. Unknown
Range check.
6.02
4j.1
Date of Previous Mammogram
6
133
138 If "Previous Mammogram" = „1‟ then enter MMYYYY (if known) or
blank fill (if unknown).
If not blank, must be a valid date. Check the skip pattern.
If "Previous Mammogram" = „2‟ or „3‟ blank fill.
MDE Version 6.0
09/2008
2-161
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
6.03
Column
Variable Name
Length
Begin
End
Codes / Format / Comments
Indication for Initial
Mammogram
1
139
139 1. Routine screening mammogram
2. Initial mammogram performed to evaluate symptoms, positive
CBE result, or previous abnormal mammogram result
3. Initial mammogram done by a non-program funded provider,
patient referred in for diagnostic evaluation.
4. Initial mammogram not done. Patient only received CBE, or
proceeded directly for other imaging or diagnostic work-up.
5. Cervical record only, breast services not done.
9. Unknown
Edit Checks/Skip Patterns
Range and skip pattern check.
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
„1‟ (Screening) should be reported for an initial
mammogram performed as part of a routine or annual
screening schedule and in the absence of symptoms or a
recent positive CBE. Items 6.05 through 6.08 should be
completed as appropriate. Item 6.04 should be blank.
„2‟ (Evaluate symptoms) should be reported for an initial
mammogram performed as additional evaluation of a
recent mammogram prior to this cycle, evaluation of current
symptoms or abnormal CBE finding. Items 6.05 through
6.08 should be completed as appropriate. Item 6.04 should
be blank.
„3‟ (Referred) should be reported when a patient has had a
mammogram performed outside of the Program, and is
referred to the Program for diagnostic work-up. Referral
Date (6.04) must be completed, and a valid Mammogram
Result (6.05) of 1 – 7, or 11 should be reported.
„4‟ (Not Done) should be reported when the patient only
received a CBE; or when the patient does not have an
initial mammogram performed and goes directly to
Diagnostic Work-up. Items 6.05 – 6.07 should be blank.
„5‟ (Cervical record only) should be reported when no
breast services are provided or reported in this record, only
cervical services. Initial Mammogram Result (6.05) should
be left blank. Additionally, items 6.04, 6.06 – 6.08 should
be blank.
MDE Version 6.0
09/2008
2-162
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
6.04
Column
Variable Name
Length
Begin
End
Codes / Format / Comments
Breast Diagnostic Referral
Date
8
140
147 If “Indication for Initial Mammogram” = “3”, enter MMDDYYYY;
otherwise leave blank
Edit Checks/Skip Patterns
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
If not blank, must be a valid date. Check the skip pattern.
See edit guidelines for skip patterns at the end of this
document.
This field should indicate the enrollment date for a patient
referred in to the program for diagnostic evaluation
following an abnormal mammogram provided outside of the
program.
6.05
4k
Initial Mammography Test
Result
(includes all mammograms
which were the first
mammogram of a screening
cycle)
Categories from the American
College of Radiology Breast
Imaging Reporting and
Database System
2
148
149
1. Negative (BI-RADS 1)
2. Benign Finding (BI-RADS 2)
3. *Probably Benign – Initial short interval follow-up
suggested (Bi-RADS 3)
4. Suspicious Abnormality - Biopsy should be considered
(BI-RADS 4)
5. Highly Suggestive of Malignancy - Appropriate action
should be taken (BI-RADS 5)
6. Assessment is Incomplete - Need additional imaging
evaluation (BI-RADS 0)
7. Unsatisfactory - This applies if the mammogram was
technically unsatisfactory and could not be interpreted by
radiologist.
10. Result pending
11. Result unknown, presumed abnormal, mammogram from
non-program funded source
13. Film comparison required (BI-RADS 0)
*Based on new BI-RADS guidance from the Fourth Edition 2003,
(3) Probably Benign should not be reported as the initial
mammogram result unless a complete work-up was performed
prior to the screening cycle either within or outside of the program.
Please refer to the Field Description in the Data User‟s Manual for
further details.
Range check.
This field should be left blank if “Indication for
Mammogram” (6.03) is „4‟ or „5‟.
If the result of the initial mammogram is „4‟, „5‟, „6‟, „11‟ or
„13‟, the Additional Breast Procedures Section must be
completed and ”Additional procedures needed to complete
breast cycle“ (6.08) should = „1‟.
A result of „7‟ (Unsatisfactory) indicates that the cycle
should be considered complete, and a new cycle will begin
with the repeat mammogram.
This variable should be the initial result of the first
mammographic film only. If any additional imaging is
needed, to obtain a final imaging result, then report „6‟. If a
film comparison is necessary to obtain a final imaging
result, then report „13‟.
MDE Version 6.0
09/2008
2-163
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
Column
New
Old
Variable Name
Length
Begin
End
Codes / Format / Comments
6.06
4l
Date of Initial Mammogram
8
150
157 If "Initial Mammography Test Result" ≤ „7‟ or „13‟ enter
MMDDYYYY.
If you know the date for „10‟ or „11‟, enter MMDDYYYY, otherwise
blank fill.
6.07
4m
Initial Mammogram Paid by
NBCCEDP Funds
1
158
158 1. Yes
2. No
3. Unknown
Edit Checks/Skip Patterns
If not blank, must be a valid date and > “Date of Previous
Mammogram” (6.02), if known. Check the skip pattern.
This field should be left blank if “Indication for
Mammogram” (6.03) is „4‟ or „5‟.
Range and skip pattern check.
This field should be left blank if “Indication for
Mammogram” (6.03) is „4‟ or „5‟.
If ”Initial Mammography Test Result“ = „10‟ and paid data are
known, then enter a „1‟ or „2‟; otherwise blank fill.
If ”Initial Mammography Test Result“ = „11‟, then this field should be
set to „2‟.
6.08
4k.1
Additional Procedures Needed
to Complete Breast Cycle
1
159
159 1. Additional procedures needed or planned.
2. Additional procedures not needed or planned.
3. Need or plan for additional procedures not yet determined
If “Indication for Mammogram” (6.03) is „1‟, „2‟, „3‟ or „4‟ this
field must be completed; otherwise, leave blank.
The purpose of this field is to indicate the need or plan for
immediate additional imaging or diagnostic work-up. In
most cases a positive mammogram (defined in 6.05) or
CBE (4.02) will indicate that a diagnostic work-up is
necessary. However, in some cases additional procedures
will be planned in the absence of an abnormal
mammogram or CBE.
If this field is coded as „1‟, the Additional Breast Procedures
Section must be completed. If this field is coded as „2‟ or
„3‟, the Additional Breast Procedures Section must be
blank.
MDE Version 6.0
09/2008
2-164
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
Column
New
Old
Variable Name
Length
Begin
End
Codes / Format / Comments
6.09
4n
MDE Version Number
2
160
161 21.
22.
23.
24.
30.
40.
41.
50.
60.
4o
Reserved
5
162
166 Reserved for future use.
For data collected through 9/30/1994
For data collected beginning 10/01/1994
For data collected beginning 10/01/1995
For data collected beginning 10/01/1996
For data collected beginning 10/01/1997
For data collected beginning 10/01/1998
For data collected beginning 10/01/1999
For data collected beginning 10/01/2002
For data collected beginning 01/01/2009
Edit Checks/Skip Patterns
The version number is indicated as a footnote to this
document. Note that the period in the version number is
not included. For example, version 5.0 will be submitted as
„50‟, version 6.0 as „60‟.
This field should be blank filled.
MDE Version 6.0
09/2008
2-165
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
Column
Variable Name
Length
Begin
End
Codes / Format / Comments
Edit Checks/Skip Patterns
Additional Cervical Procedures Section - This section must be completed if Diagnostic Work-up Planned for Cervical Dysplasia or Cancer (5.16) = „1‟ (planned), otherwise leave blank.
7. Cervical Diagnostic Procedures
7.01
1a.1
Colposcopy without Biopsy
1
167
167 1. Yes
2. No
Range check. See edit guideline for range checks at the
end of this document.
7.02
1a.2
Colposcopy with Biopsy
and/or ECC
1
168
168 1. Yes
2. No
Range check.
Loop Electrosurgical Excision
Procedure (LEEP)
1
169
169 1. Yes
2. No
Range check.
7.03
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
7.04
Cold Knife Cone (CKC)
1
170
170 1. Yes
2. No
Range check.
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
7.05
Endocervical Curettage alone
(ECC)
1
171
171 1. Yes
2. No
Range check.
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
7.06
1a.3
Other Cervical Procedures
Performed
1
172
172 1. Yes
2. No
Range check.
7.07
1a.3
Other Cervical Procedures
Performed Description (from
7.06)
40
173
212 Free text format, description of "Other Cervical Procedures
Performed".
Check the skip pattern. See edit guideline for skip pattern
checks at the end of this document.
7.08
1a.4
Cervical Diagnostic
Procedures Paid by
NBCCEDP Funds
1
213
213 1. Yes
2. No
3. Unknown
If at least one cervical diagnostic procedure was paid by
NBCCEDP Funds, then this field should be set to „1‟.
MDE Version 6.0
09/2008
2-166
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
Column
Variable Name
Codes / Format / Comments
Length
Begin
End
1
214
214 1. Work-up complete
2. Work-up pending
3. Lost to follow-up
4. Work-up refused
9. Irreconcilable
Edit Checks/Skip Patterns
8. Cervical Diagnosis Information
8.01
1c
Status of Final Diagnosis
Range check.
A status of “Work-up complete” means that the diagnostic
testing is complete, and that “Final Diagnosis” (8.02) and
“Date of Final Diagnosis” (8.04) are known.
A response of “9” will be used for those records, which after clinical
review; it was determined that there was no sufficient way to
translate the clinical scenario into the MDE data record. An
example would be: If the clinician refers the woman for short-term
follow-up instead of following the guideline for immediate diagnostic
work-up, enter a „9‟ to indicate a closed cycle with an irreconcilable
status.
8.02
1b
Final Diagnosis
1
215
215 1. Normal/Benign reaction/inflammation
2. HPV/Condylomata/Atypia
3. CINI/mild dysplasia (biopsy diagnosis)
4. CINII/moderate dysplasia (biopsy diagnosis)
5. CINIII/severe dysplasia/Carcinoma in situ (Stage 0) or
Adenocarcinoma In Situ of the cervix (AIS) (biopsy diagnosis)
6. Invasive Cervical Carcinoma (biopsy diagnosis)
7. Other
8. Low grade SIL (biopsy diagnosis)
9. High grade SIL (biopsy diagnosis)
Range check.
Check the skip pattern.
Low grade SIL and High grade SIL are provided as
alternatives to diagnoses 2-5 and only one diagnosis
should be submitted.
Invasive Adenocarcinoma of the cervix should be coded as
a „6‟ (Invasive Cervical Carcinoma). Adenocarcinoma In
Situ (AIS) of the cervix should be coded as „5‟ (CIN3/severe
dysplasia/CIS/AIS).
8.03
1b.7
Final Diagnosis - Other
20
216
235 Free text format, Description of "Final Diagnosis - Other".
8.04
1d
Date of Final Diagnosis
8
236
243 If Status of Final Diagnosis (8.01) = „1‟ enter MMDDYYYY, the date Check the skip pattern. If not blank, should be ≥ “Date of
of diagnosis of cancer or precancerous lesion or date the decision Pap Test” (5.11) in All Patients Section. See edit
made that no cancer present.
guidelines for dates at the end of this document.
If Status of Final Diagnosis (8.01) = „2‟ then blank fill.
If Status of Final Diagnosis (8.01) = „3‟, „4‟ or „9‟ then enter
MMDDYYYY, the date of administrative closeout.
MDE Version 6.0
09/2008
2-167
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
Column
New
Old
Variable Name
Length
Begin
End
8.05
1b6a
Stage at Diagnosis
1
244
244 If Final Diagnosis (8.02) is a „6‟ then enter one of the following:
1. Stage I
2. Stage II
3. Stage III
4. Stage IV
5. Summary Local
6. Summary Regional
7. Summary Distant
8. Unknown/Unstaged
LEGACY DATA ONLY.
This section is used to
report stage data on all
cancer records with initial
screens prior to 1/1/2004; or
stage data not acquired
through state cancer
registries.
Codes / Format / Comments
If "Final Diagnosis" is NOT a „6‟, blank fill.
Use Section 14 to report
cancer data acquired
through state cancer
registries for screens dating
from 1/1/2004.
Edit Checks/Skip Patterns
Range and skip pattern check.
This field is not intended for use for cervical screens
beginning 01/01/2009 when it is superseded by Registry
Data fields (14.01 – 14.11). However, it may be optionally
reported, in addition to required registry fields, for data
collected from providers.
If clinical stage is available, report using International
Federation of Gynecology and Obstetrics (FIGO)/American
Joint Committee on Cancer (AJCC), Fifth Edition, 1997.
FIGO/AJCC stage can be reported as pathological or
clinical. FIGO/AJCC clinical stage is preferred over
pathological stage which is preferred over summary stage.
9. Cervical Cancer Treatment Information – This section is completed based on the results of MDE Item 8.02 (Final Diagnosis).
9.01
2a
Status of Treatment
1
245
245 If Final Diagnosis (8.02) = „4‟, „5‟, „6‟, or „9‟ then complete 9.01 and
9.02.
If Final Diagnosis (8.02) = „2‟, „3‟, „7‟, or „8‟ then 9.01 and 9.02 MAY
be completed.
If Final Diagnosis (8.02) = „1‟, then 9.01 and 9.02 should be left
blank.
1. Treatment started
2. Treatment pending
3. Lost to follow-up
4. Treatment refused
5. Treatment not needed
A woman should be classified as having started treatment
when the Program has confirmed that a plan for treatment
of the cancer or precancerous lesion has been developed
and started.
Range and skip pattern check.
If a woman dies before treatment has started, enter a „3‟ (Lost to
follow-up).
9.02
2b
Date of Treatment Status
8
246
253 If Status of Treatment (9.01) = „1‟ enter MMDDYYYY, the date that
treatment of cancer or precancerous lesion began.
If Status of Treatment (9.01) = „2‟ then blank fill.
If Status of Treatment (9.01) = „3‟, „4‟, or „5‟ then enter
MMDDYYYY, the date of administrative closeout.
Check the skip pattern. If not blank, should be ≥ “Date of
Final Diagnosis” (8.04).
2c
Reserved
5
254
258 Reserved for future use.
This field should be blank filled.
MDE Version 6.0
09/2008
2-168
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
Column
Variable Name
Length
Begin
End
Codes / Format / Comments
Edit Checks/Skip Patterns
Additional Breast Procedures Section: This section must be completed if Additional Procedures Needed (6.08) = „1‟ (Needed/Planned). Otherwise, leave blank.
10. Breast Imaging Procedures
10.01
1a.1
Additional Mammographic
Views
1
259
259 1. Yes
2. No
Range check. See edit guideline for range checks at the
end of this document.
10.02
1a3
Ultrasound
1
260
260 1. Yes
2. No
Range check.
Film Comparison to evaluate
an Assessment Incomplete
1
261
261 1. Yes
2. No/Not Applicable
Range check.
10.03
Code „1‟ (Yes) if film comparison was done when required
to further evaluate an Initial Mammogram Test Result as
Assessment Incomplete (6.05 = 6 or 13); otherwise, code
„2‟ (No/Not Applicable) if film comparison was not done or
done as part of standard imaging evaluation.
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
MDE Version 6.0
09/2008
2-169
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
10.04
Column
Variable Name
Length
Begin
End
Codes / Format / Comments
Final Imaging Outcome
1
262
262 1. Negative (BI-RADS 1)
2. Benign Finding (BI-RADS 2)
3. Probably Benign - Short interval follow-up indicated
(BI-RADS 3)
4. Suspicious Abnormality - Biopsy should be considered
(BI-RADS 4)
5. Highly Suggestive of Malignancy - Appropriate action should be
taken (BI-RADS 5)
7. Unsatisfactory - This applies if the additional imaging result was
technically unsatisfactory and final assessment could not be
made.
8. Additional imaging pending
Edit Checks/Skip Patterns
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
This is the assessment from all imaging procedures,
including comparison with previous films, needed to arrive
at a final outcome. Assessment incomplete is NOT an
option; however, if programs experience a delay in
receiving comparison films or additional imaging results
they should report ‟8‟ (Additional imaging pending).
If no additional breast imaging procedures (10.01 through
10.03) were performed, this field should be left blank.
If at least one procedure was planned, but patient refused
the procedure, or was lost to follow-up prior to its
completion, please indicate this in “Status of Final
Diagnosis/Imaging” (12.01).
10.05
Date of Final Imaging
Outcome
8
263
270 If Final Imaging Outcome (10.04) ≤ „5‟ or „7‟, enter MMDDYYYY.
If Final Imaging Outcome (10.04) = „8‟ blank fill.
Data collection for this field is effective 01/01/2009.
Historical data can be reported if accurately collected;
otherwise, leave blank.
If not blank, must be a valid date and ≥ the “Date of Initial
Mammogram” (6.06) if known. Check the skip pattern.
If additional imaging is performed on more than one date,
report the date of the last procedure used to determine a
final imaging outcome.
11. Breast Diagnostic Procedures
11.01
1a.2
Repeat Breast Exam/
Surgical Consultation
1
271
271 1. Yes
2. No
Range check.
11.02
1a.4
Biopsy/Lumpectomy
1
272
272 1. Yes
2. No
Range check.
MDE Version 6.0
09/2008
2-170
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
Column
New
Old
Variable Name
Length
Begin
End
Codes / Format / Comments
Edit Checks/Skip Patterns
11.03
1a.5
Fine Needle/Cyst Aspiration
1
273
273 1. Yes
2. No
Range check.
11.04
1a.6
Other Breast Procedures
Performed
1
274
274 1. Yes
2. No
Range check.
11.05
1a.6
Other Breast Procedures
Performed Description
(from 11.04)
40
275
314 Free text format, Description of "Other Breast Procedures
Performed"
Check the skip pattern. See edit guideline for skip patterns
at the end of this document.
11.06
1a.7
Additional Breast Procedures
Paid by NBCCEDP Funds
1
315
315 1. Yes
2. No
3. Unknown
If at least one of the additional breast procedures was paid
by NBCCEDP Funds, then this field should be set to „1‟
(Yes).
1
316
316 1. Work-up complete
2. Work-up pending
3. Lost to follow-up
4. Work-up refused
9. Irreconcilable
Range check.
12. Breast Final Diagnosis Information
12.01
1c
Status of Final
Diagnosis / Imaging
A status of “Work-up complete” means that all additional
imaging and diagnostic testing (if applicable) is complete,
and that the “Final Diagnosis” (12.02) and “Date of Final
Diagnosis” (12.03) are known.
A response of ‟9‟ will be used for those records, which after clinical
review; it was determined that there was no sufficient way to
translate the clinical scenario into the MDE data record. An
example would be: If the clinician refers the woman for short-term
follow-up instead of following the guideline for immediate diagnostic
work-up, enter a „9‟ to indicate a closed cycle with an irreconcilable
status.
12.02
1b
Final Diagnosis
1
317
317 1. Carcinoma In Situ, Other*
2. Invasive Breast Cancer
3. Breast Cancer Not Diagnosed
4. Lobular Carcinoma In Situ (LCIS) - (Stage 0)
5. Ductal Carcinoma In Situ (DCIS ) - (Stage 0)
Range check.
If a patient gets additional imaging procedures and a Final
Imaging Outcome that requires no further diagnostic
procedures, then this field should be coded as „3‟ (Breast
Cancer Not Diagnosed).
*Category (1) - CIS, Other is not a current reporting option for Final
Diagnosis. It was used to report CIS diagnoses prior to
10/01/1999.
MDE Version 6.0
09/2008
2-171
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
Column
New
Old
Variable Name
Length
Begin
End
Codes / Format / Comments
12.03
1d
Date of Final
Diagnosis / Imaging
8
318
325 If Status of Final Diagnosis/Imaging = „1‟, then enter MMDDYYYY,
the date of diagnosis of cancer or date that decision made that no
cancer present.
Edit Checks/Skip Patterns
Check the skip pattern. If not blank, should be ≥ “Date of
Initial Mammogram” (6.06) or “Clinical Breast Exam Date”
(4.03) in All Patients Section. See edit guidelines for dates
at the end of this document.
If Status of Final Diagnosis/Imaging = „2‟, then blank fill.
If Status of Final Diagnosis/Imaging = „3‟, „4‟ or „9‟ then enter
MMDDYYYY, the administrative date of closeout of this episode.
12.04
1b2a
Stage at Diagnosis
LEGACY DATA ONLY.
This section is used to
report stage data on all
cancer records with initial
screens prior to 1/1/2004; or
stage data not acquired
through state cancer
registries.
Use Section 15 to report
cancer data acquired
through state cancer
registries for screens dating
from 1/1/2004.
1
326
326 If Final Diagnosis is a „2‟ (Invasive Breast Cancer) then enter one
of the following:
1. AJCC Stage I
2. AJCC Stage II
3. AJCC Stage III
4. AJCC Stage IV
5. Summary Local
6. Summary Regional
7. Summary Distant
8. Unknown/Unstaged
If Final Diagnosis is a „1‟, „3‟, „4‟ or „5‟ then blank fill.
If only additional imaging was performed [10.01, 10.02, or
10.03 = „1‟ (Yes)] then this date should be the same as
“Date of Final Imaging Outcome” (10.05). If any additional
“non-imaging” procedures were performed, the “Date of
Final Diagnosis/Imaging” (10.05) should be the date of the
definitive procedure indicating cancer or not cancer.
Range and skip pattern check.
This field is not intended for use for breast screens
beginning 01/01/2009 when it is superseded by Registry
Data fields (15.01 – 15.11). However, it may be optionally
reported, in addition to required registry fields, for data
collected from providers.
The staging data should be reported using pathological
stage, which includes clinical staging information,
according to AJCC, Fifth Edition, 1997. AJCC staging may
be reported as pathological or clinical stage. AJCC stage
(pathological or clinical) is preferred over summary stage.
MDE Version 6.0
09/2008
2-172
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
Column
New
Old
Variable Name
Length
Begin
End
12.05
1b2b
Tumor Size
1
327
327 If Final Diagnosis is a „2‟ (Invasive Breast Cancer) then enter one
of the following:
1. 0 to ≤1 cm
2. > 1 to ≤ 2 cm
3. > 2 to ≤ 5 cm
4. > 5 cm
5. Unknown
LEGACY DATA ONLY.
This section is used to report
stage data on all cancer
records with initial screens
prior to 1/1/2004; or stage data
not acquired through state
cancer registries.
Codes / Format / Comments
Edit Checks/Skip Patterns
Range and skip pattern check.
This field is not intended for use for breast screens
beginning 01/01/2009 when it is superseded by Registry
Data fields (15.01 – 15.11). However, it may be optionally
reported, in addition to required registry fields, for data
collected from providers.
If Final Diagnosis is a „1‟, „3‟, „4‟ or „5‟ then blank fill.
Use Section 15 to report
cancer data acquired through
state cancer registries for
screens dating from 1/1/2004.
13. Breast Cancer Treatment Information – This section is completed based on the results of Final Diagnosis (12.02).
13.01
2a
Status of Treatment
1
328
328 If Final Diagnosis (12.02) = „1‟, „2‟ or „5‟ then complete 13.01 and
13.02.
If Final Diagnosis (12.02) = „4‟, then 13.01 and 13.02 MAY be
completed.
If Final Diagnosis (12.02) = „3‟, then 13.01 and 13.02 should be
blank.
1. Treatment started
2. Treatment pending
3. Lost to follow-up
4. Treatment refused
5. Treatment not needed
Range and skip pattern check.
A woman should be classified as having started treatment
when the Program has confirmed that a plan for treatment
of the cancer or precancerous lesion has been developed
and started.
If a woman dies before treatment has started, enter a „3‟ (Lost to
follow-up).
13.02
2b
Date of Treatment Status
8
329
336 If Status of Treatment (13.01) = „1‟, then enter MMDDYYYY, the
date that treatment for cancer began.
Check the skip pattern. If not blank, should be ≥ “Date of
Final Diagnosis” (12.03).
If Status of Treatment (13.01) = „2‟, then blank fill.
If Status of Treatment (13.01) = „3‟, „4‟, or „5‟ then enter
MMDDYYYY, the date of administrative closeout.
2c
Reserved
5
337
341 Reserved for future use.
This field should be blank filled.
MDE Version 6.0
09/2008
2-173
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
Column
Variable Name
Length
Begin
Codes / Format / Comments
End
Edit Checks/Skip Patterns
14. Cervical Cancer Registry Data – If Final Diagnosis (8.02) is a ‘6’ (Invasive Cervical Carcinoma) and the patient was screened as of January 1, 2004, then this section must be
completed. This section is reserved for data acquired through a State Central Cancer Registry or an equivalent data source approved by CDC/IMS.
NAACCR Record Data Standards and Data Dictionary are available at www.naaccr.org.
14.01
Registry Linkage Status
1
342
342 1. Linkage process pending
2. Linkage process complete, record matched
3. Linkage process attempted, record not matched
Range check.
14.02
Registry Date of Diagnosis
8
343
350 MMDDYYYY
Leave blank if 14.01 = 1, 3.
[NAACCR data item #390]
14.03
Registry Histologic Type
If not blank, must be a valid date.
4
351
[NAACCR data item #522]
14.04
Registry Behavior
A complete list of valid values/labels will be provided for reference
in Chapter 3 of the Data User’s Manual.
1
355
[NAACCR data item #523]
14.05
Registry Summary Stage
[NAACCR data item:
#3020 When 14.02 ≥
1/1/2004
#759 When 14.02 =
1/1/2001 – 12/31/2003
#760 When 14.02 ≤
12/31/2000]
354 Range: 8000-9989
1
356
Range check.
Leave blank if 14.01 = 1, 3.
355 0. Benign
1. Uncertain whether benign or malignant/Borderline malignancy
2. Carcinoma In Situ
3. Malignant
Range check.
356 0. In situ (IS)
1. Localized (L)
2. Regional, direct extension only (RE)
3. Regional, regional lymph nodes only (RN)
4. Regional, extension and nodes (RE+RN)
5. Regional, NOS (RNOS)
7. Distant (D)
8. Not Applicable (NA)
9. Unknown/unstaged (U)
Range check.
Leave blank if 14.01 = 1, 3.
Leave blank if 14.01 = 1, 3.
Note: These NAACCR data items are specific to definitions
in place for the calendar year of the Registry Date of
Diagnosis (14.02).
MDE Version 6.0
09/2008
2-174
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
14.06
Column
Variable Name
Length
Begin
End
Registry Collaborative Stage
(CS) – Derived AJCC Stage
Group
2
357
358 Range: 00-99
Registry Collaborative Stage
(CS) Tumor Size
Edit Checks/Skip Patterns
Range check.
Valid values for CS-derived AJCC stage include: 00-02, 10-24, 30- Leave blank if 14.01 = 1, 3.
43, 50-63, 70-74, 88, 90, 99.
Complete only if Registry Date of Diagnosis (14.02) ≥
A complete list of valid values/labels will be provided for reference 01/01/2004; otherwise leave blank.
in Chapter 3 of the Data User’s Manual.
[NAACCR data item #3000]
14.07
Codes / Format / Comments
3
359
361 If Final Diagnosis is a „6‟ (Invasive Cervical Carcinoma) then enter
one of the following:
Range check.
Leave blank if 14.01 = 1, 3.
[NAACCR data item #2800]
001-988 Exact size in millimeters
989. ≥ 989 millimeters
990. Microscopic focus or foci only; no size of focus is given
991. Described as less than 1 cm
992. Described as less than 2 cm
993. Described as less than 3 cm
994. Described as less than 4 cm
995. Described as less than 5 cm
999. Unknown; size not stated
Complete only if Registry Date of Diagnosis (14.02) ≥
01/01/2004; otherwise leave blank.
In the event that the NBCCEDP diagnosis is confirmed by the
cancer registry to be a Lymphoma diagnosis (Item 14.03 = 95909699, 9702-9729, 9823, 9827), the following value should be used
to report CS – Tumor Size: 888 = Not applicable.
If Final Diagnosis is „1‟, „2‟, „3‟, „4‟, „5‟, „7‟, „8‟ or „9‟, leave blank.
See most current version of the CS Staging Manual:
http://www.cancerstaging.org/cstage/manuals.html
v01.03.00 (Sept 2006), Part I, pg 25
MDE Version 6.0
09/2008
2-175
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
14.08
Column
Variable Name
Length
Begin
End
Codes / Format / Comments
Registry Collaborative Stage
(CS) Extension
2
362
363 Range: 00 – 99
Edit Checks/Skip Patterns
Range check.
Valid values for CS extension include: 00, 01, 11-12, 20, 25, 30-31, Leave blank if 14.01 = 1, 3.
35- 40, 50, 60, 62-63, 65, 68, 70, 80, 95, 99.
Complete only if Registry Date of Diagnosis (14.02) ≥
In the event that the NBCCEDP diagnosis is confirmed by the
01/01/2004; otherwise leave blank.
cancer registry to be a Lymphoma diagnosis (14.03 = 9590-9699,
9702-9729, 9823, 9827), the following values should be used to
report CS - Extension: 10-12, 20-23, 30-33, 80, and 99. These
values will have different definitions than those listed above for
cervical cancer.
[NAACCR data item #2810]
A complete list of valid values/labels will be provided for reference
in Chapter 3 of the Data User’s Manual.
See most current version of the CS Staging Manual:
http://www.cancerstaging.org/cstage/manuals.html
v01.03.00 (Sept 2006), Part II, pg 389
14.09
Registry Collaborative Stage
(CS) Lymph Nodes
2
364
365 Range 00 – 99
Range check.
Valid values for CS lymph nodes include: 00, 10, 80, 99.
Leave blank if 14.01 = 1, 3.
In the event that the NBCCEDP diagnosis is confirmed by the
cancer registry to be a Lymphoma diagnosis (14.03 = 9590-9699,
9702-9729, 9823, 9827), the following value should be used to
report CS – Lymph Nodes: 88 = Not applicable.
Complete only if Registry Date of Diagnosis (14.02) ≥
01/01/2004; otherwise leave blank.
[NAACCR data item #2830]
A complete list of valid values/labels will be provided for reference
in Chapter 3 of the Data User’s Manual.
See most current version of the CS Staging Manual:
http://www.cancerstaging.org/cstage/manuals.html
v01.03.00 (Sept 2006), Part II, pg 391
MDE Version 6.0
09/2008
2-176
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
14.10
Column
Variable Name
Length
Begin
End
Codes / Format / Comments
Registry Collaborative Stage
(CS) Mets at Diagnosis
2
366
367 Range 00 – 99
Edit Checks/Skip Patterns
Range check.
Valid values for CS mets at diagnosis include: 00, 10, 40, 50, 99.
Leave blank if 14.01 = 1, 3.
In the event that the NBCCEDP diagnosis is confirmed by the
cancer registry to be a Lymphoma diagnosis (14.03 = 9590-9699,
9702-9729, 9823, 9827), the following value should be used to
report CS – Mets at Diagnosis: 88 = Not applicable for this site.
Complete only if Registry Date of Diagnosis (14.02)
≥01/01/2004; otherwise leave blank.
[NAACCR data item #2850]
A complete list of valid values/labels will be provided for reference
in Chapter 3 of the Data User’s Manual.
See most current version of the CS Staging Manual:
http://www.cancerstaging.org/cstage/manuals.html
v01.03.00 (Sept 2006), Part II, pg 392
14.11
Registry Primary Site
[NAACCR data item #400]
4
368
371 C000 – C999
Range check.
NOTE: The „C‟ must be included as part of the variable response in Leave blank if 14.01 = 1, 3.
the MDE file. For example, Endocervix = C530. A complete list of
valid values/labels for this item will be provided for reference in the Complete only if Registry Date of Diagnosis (14.02) ≥
Data User‟s Manual.
01/01/2004; otherwise leave blank.
MDE Version 6.0
09/2008
2-177
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
Column
Variable Name
Length
Begin
Codes / Format / Comments
End
Edit Checks/Skip Patterns
15. Breast Cancer Registry Data – If Final Diagnosis (12.02) is a ‘1’ (Carcinoma In Situ, Other), ‘2’ (Invasive Breast Cancer), ‘4’ (Lobular Carcinoma In Situ) or ‘5’ (Ductal Carcinoma In
Situ) and the patient was screened as of January 1, 2004, then this section must be completed. This section is reserved for data acquired through a State Central Cancer Registry or an
equivalent data source approved by CDC/IMS.
NAACCR Record Data Standards and Data Dictionary are available at www.naaccr.org.
15.01
Registry Linkage Status
1
372
372 1. Pending linkage
2. Linked, matched
3. Linked, not matched
Range check.
15.02
Registry Date of Diagnosis
8
373
380 MMDDYYYY
Leave blank if 15.01 = 1, 3.
[NAACCR data item #390]
15.03
Registry Histologic Type
If not blank, must be a valid date.
4
381
[NAACCR data item #522]
15.04
Registry Behavior
A complete list of valid values/labels will be provided for reference
in Chapter 3 of the Data User’s Manual.
1
385
[NAACCR data item #523]
15.05
Registry Summary Stage
[NAACCR data item:
#3020 When 15.02 ≥
1/1/2004
#759 When 15.02 =
1/1/01- 12/31/03
#760 When 15.02 ≤
12/31/2000]
384 Range: 8000-9989
1
386
Range check.
Leave blank if 15.01 = 1, 3.
385 0. Benign
1. Uncertain whether benign or malignant/Borderline malignancy
2. Carcinoma In Situ
3. Malignant
Range check.
386 0. In situ (IS)
1. Localized (L)
2. Regional, direct extension only (RE)
3. Regional, regional lymph nodes only (RN)
4. Regional, extension and nodes (RE+RN)
5. Regional, NOS (RNOS)
7. Distant (D)
8. Not Applicable (NA)
9. Unknown/unstaged (U)
Range check.
Leave blank if 15.01 = 1, 3.
Leave blank if 15.01 = 1, 3.
Note: These NAACCR data items are specific to definitions
in place for the calendar year of the Registry Date of
Diagnosis (15.02).
MDE Version 6.0
09/2008
2-178
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
15.06
Column
Variable Name
Length
Begin
End
Registry Collaborative Stage
(CS) – Derived AJCC Stage
group
2
387
388 Range: 00-99
Registry Collaborative Stage
(CS) Tumor Size
Edit Checks/Skip Patterns
Range check.
Valid values for CS-derived AJCC stage include: 00-02, 10-24, 30- Leave blank if 15.01 = 1, 3.
43, 50-63, 70-74, 88, 90, 99.
Complete only if Registry Date of Diagnosis (15.02) ≥
A complete list of valid values/labels will be provided for reference 01/01/2004; otherwise leave blank.
in Chapter 3 of the Data User’s Manual.
[NAACCR data item #3000]
15.07
Codes / Format / Comments
3
389
391 If Final Diagnosis is a „1‟ (Carcinoma In Situ, Other), „2‟ (Invasive
Breast Cancer), „4‟ (Lobular Carcinoma In Situ) or „5‟ (Ductal
Carcinoma In Situ) then enter one of the following:
Range check and skip pattern check.
Leave blank if 15.01 = 1, 3.
[NAACCR data item #2800]
001-988 Exact size in millimeters
989. ≥ 989 millimeters
990. Microscopic focus or foci only; no size of focus is given
991. Described as less than 1 cm
992. Described as between 1 cm and 2 cm
993. Described as between 2 cm and 3 cm
994. Described as between 3 cm and 4 cm
995. Described as between 4 cm and 5 cm
996. Mammographic/xerographic diagnosis only, no size given;
clinically not palpable
997. Paget‟s Disease of nipple with no demonstrable tumor
998. Diffuse
999. Unknown; size not stated
Complete only if Registry Date of Diagnosis (15.02) ≥
01/01/2004; otherwise leave blank.
In the event that the NBCCEDP diagnosis is confirmed by the
cancer registry to be a Lymphoma diagnosis (15.03 = 9590-9699,
9702-9729, 9823, 9827), the following value should be used to
report CS - Tumor Size: 888 = Not applicable.
If Final Diagnosis is a „3‟ then blank fill.
See most current version of the CS Staging Manual:
http://www.cancerstaging.org/cstage/manuals.html
v01.03.00 (Sept 2006), Part II, pg 371
MDE Version 6.0
09/2008
2-179
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
15.08
Column
Variable Name
Length
Begin
End
Codes / Format / Comments
Registry Collaborative Stage
(CS) Extension
2
392
393 Range: 00 – 99
Valid values for CS extension include: 00, 05, 07, 10, 20,30, 40,
51-52, 61-62, 71- 73, 95, 99
[NAACCR data item #2810]
In the event that the NBCCEDP diagnosis is confirmed by the
cancer registry to be a Lymphoma diagnosis (15.03 = 9590-9699,
9702-9729, 9823, 9827), the following values should be used to
report CS - Extension: 10-12, 20-23, 30-33, 80, and 99. These
values will have different definitions than those listed above for
breast cancer.
Edit Checks/Skip Patterns
Range check.
Leave blank if 15.01 = 1, 3.
Complete only if Date of Diagnosis (15.02) ≥ 01/01/2004;
otherwise leave blank.
A complete list of valid values/labels will be provided for reference
in Chapter 3 of the Data User’s Manual.
See most current version of the CS Staging Manual:
http://www.cancerstaging.org/cstage/manuals.html
v01.03.00 (Sept 2006), Part II, pg 372
15.09
Registry Collaborative Stage
(CS) Lymph Nodes
[NAACCR data item #2830]
2
394
395 Range 00 – 99
Valid values for CS lymph nodes include: 00, 05, 13, 15, 25-26,
28-30, 50- 52, 60, 71- 80, 99.
In the event that the NBCCEDP diagnosis is confirmed by the
cancer registry to be a Lymphoma diagnosis (15.03 = 9590-9699,
9702-9729, 9823, 9827), the following value should be used to
report CS – Lymph Nodes: 88 = Not applicable.
Range check.
Leave blank if 15.01 = 1, 3.
Complete only if Registry Date of Diagnosis (15.02) ≥
01/01/2004; otherwise leave blank.
A complete list of valid values/labels will be provided for reference
in Chapter 3 of the Data User’s Manual.
See most current version of the CS Staging Manual:
http://www.cancerstaging.org/cstage/manuals.html
v01.03.00 (Sept 2006), Part II, pg 374
MDE Version 6.0
09/2008
2-180
National Breast and Cervical Cancer Early Detection Program
Minimum Data Elements (MDE) Data Definition
Item Number
New
Old
15.10
Column
Variable Name
Length
Begin
End
Codes / Format / Comments
Registry Collaborative Stage
(CS) Mets at Diagnosis
2
396
397 Range 00 – 99
Valid values for CS mets at diagnosis include: 00, 10, 40, 42, 44,
50, 99.
[NAACCR data item #2850]
In the event that the NBCCEDP diagnosis is confirmed by the
cancer registry to be a Lymphoma diagnosis (15.03 = 9590-9699,
9702-9729, 9823, 9827), the following value should be used to
report CS – Mets at Diagnosis: 88 = Not applicable for this site.
Edit Checks/Skip Patterns
Range check.
Leave blank if 15.01 = 1, 3.
Complete only if Registry Date of Diagnosis (15.02) ≥
01/01/2004; otherwise leave blank.
A complete list of valid values/labels will be provided for reference
in Chapter 3 of the Data User’s Manual.
See most current version of the CS Staging Manual:
http://www.cancerstaging.org/cstage/manuals.html
v01.03.00 (Sept 2006), Part II, pg 376
15.11
Registry Primary Site
4
398
[NAACCR data item #400]
401 C000 – C999
Range check.
NOTE: The „C‟ must be included as part of the variable response in Leave blank if 15.01 = 1, 3.
the MDE file. For example, Breast NOS = C509. A complete list of
valid values/labels for this item will be provided for reference in the Complete only if Registry Date of Diagnosis (15.02) ≥
Data User‟s Manual.
01/01/2004; otherwise leave blank.
99. End of Record Mark – Completed for each MDE record
End of Record/Newline
1
402
402 Character that ends the current record and begins a new line of
text.
Example: Carriage Return-Line Feed
General edit guidelines for:
Dates: If your data processing system does not store dates as complete dates (i.e. they are separate month, day, and year fields), you need to verify the individual fields. The month needs to be between 1 and 12 and the
day, if specified, between 1 and 31 and appropriate for the month (i.e. no June 31). A common situation for some dates could be that the year is known, but the month or day is not. If this occurs, please blank fill only the
unknown fields.
Correct date sequences: A correct sequence of dates that track screening, diagnosis, and treatment is very important. These relationships have been specified in the edit section above. Please check these date
relationships to ensure that the date sequences are reasonable.
Range checks: These are performed on fields like Hispanic Origin (3.05), Race (3.06.x), Breast Symptoms (4.01), etc. where specific values are requested. A simple check of these data before they are submitted will
ensure that, for example, Hispanic Origin only has values of „1‟ to „3‟ as specified in the MDE documentation.
Skip patterns: There are fields in the MDEs that are supposed to be completed under certain circumstances and left blank in others. For example, Clinical Breast Exam Date (4.03) should only be completed if Clinical
Breast Exam (4.02) is a „1‟ or „2‟. Thus please check to see that if, for example, 10 women have a „1‟ or a „2‟ for Clinical Breast Exam, that there are no more than 10 Clinical Breast Exam Dates (4.03).
MDE Version 6.0
09/2008
2-181
File Type | application/pdf |
File Title | National Breast and Cervical Cancer Early Detection Program |
Author | Mattingl |
File Modified | 2015-03-23 |
File Created | 2008-09-05 |