Solid Tumor Rules Changes for 2022 - Colon

Patricia Hines, CTR Solid Tumor Rules Leave a Comment

Solid Tumor Rules Changes for 2022 - Colon

Effective September 1, 2021, for all cases diagnosed January 1, 2022 and forward. 

As stated in the SEER online article, What is a Cancer Registry?, “cancer registries receive and collect data about cancer patients,” that is securely stored and submitted to other organizations, such as state Central Registries, SEER (Surveillance, Epidemiology, and End Results Program), NCDB (National Cancer Database), and other organizations. This information is then used by these organizations, such as “the SEER Program” which “receives the de-identified information - free of any identifiers of cancer patients” and “makes the data available to researchers and the public who are looking for cancer statistics such as incidence, mortality, survival, and prevalence. This information is disseminated in the form of fact sheets, reports, publications, media, research databases, and websites.” Cancer Registry, as with most things in life, requires changes to be made from time to time to keep up with advancements or to expand our knowledge as we continue to grow and learn new things every day.   

Cancer registry guidelines and rules are written and developed by what the field calls, “Standard Setters.” Some of the organizations that are a part of this elite group are “The World Health Organization (WHO), the American Cancer Society (ACS), and the American Joint Committee on Cancer (AJCC).” At times, each of the organizations need to make changes to their guidelines, but it is important that they don’t all make changes at the same time. When one organization makes changes, it has to work smoothly with the requirements of other organizations. The last major changes in the world of cancer registry were in 2018. The large number of changes made trickled down and caused issues in other areas such as the release date of the registry software from the software vendors. This delay in turn delayed the processing of cancer abstracts and submissions to other organizations to be used in research. For 2021, we are seeing additional changes being made by some standard setters, but in a lesser degree. 

This week we are continuing our review of some of the new rule changes to the Solid Tumor Rules. In the last two weeks we reviewed rule changes for head/  neck cancers and breast cancer. This week we are covering new changes being made to colon cancer. 

Per the “September 2021 Revision History for Solid Tumor Rules” and the “Colon Solid Tumor Rules,” the following new changes have been revised for the colon section. 

Equivalent or Equal Terms 
  • Clarification added for "Carcinoma; Adenocarcinoma": 
    • "A histology type must be stated for these terms to be equal" 
    • Example added: "Mucinous carcinoma and mucinous adenocarcinoma are both coded 8480" 
Terms that are NOT Equivalent or Equal 
  • Carcinoma, NOS 8010 is not equivalent to adenocarcinoma, NOS 8140 
Table 1: Specific Histologies, NOS/ NST, and Subtypes/Variants 
  • Adenocarcinoma row: 
    • NEW "High grade appendiceal mucinous neoplasm (HAMN)/Low grade appendiceal mucinous neoplasm 8480- see Note 3" added 
    • Note 3 added: "Effective 1/1/2022, LAMN becomes reportable and is coded 8480/2, unless the pathologist indicates invasive behavior, which is coded 8480/3. HAMN can be either /2 or /3 depending on the pathologist statement of behavior." 
Table 2: Histologies Not Reportable for Colon, Rectosigmoid and Rectum 
  • New polyp terminologies added: 
    • Adenomatous polyp, high grade dysplasia 8210/2 
    • Intestinal-type adenoma, high grade 8144/2 
    • Serrated dysplasia, high grade 8213/2 
    • Tubular adenoma, high grade 8211/2 
    • Villous adenoma, high grade 8261/2 
  • LAMN row: 
    • Note added: "Note: LAMN is non-reportable for cases diagnosed prior to 1/1/2022. Beginning 1/1/2022, LAMN becomes a reportable neoplasm- See Table 1" 
Histology Rules 
  • NEW rule: "Code low grade appendiceal mucinous neoplasm (LAMN) and high grade appendiceal mucinous neoplasm (HAMN) 8480/2 when…" 
  • NEW Mucinous Adenocarcinoma rule: 
    • LAMN/HAMN terminology added
  • NEW Anastomosis rules:
    • Timing interval changed from 24 to 36 months 


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