Solid Tumor Rules Changes for 2022 - Head and Neck

Patricia Hines, CTR Oncology Leave a Comment

Solid Tumor Rules Changes for 2022 - Head and Neck

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

Daily cancer abstracting requires the use of many manuals to abstract a patient’s case daily. One such manual is the Solid Tumor Rules manual by the Surveillance, Epidemiology, and End Results Program (SEER). The use of this manual, which according to the CancerRegistryeducation.org website, is a “manual” that “promotes consistent and standardized coding by cancer registries to determine the number of primaries and histology codes.” It is used by an abstractor to determine if a specific case has multiple primaries or has only a single primary.  The number of primaries is based on many factors from the amount of time between two separate positive biopsies of the same site, to similar histologies and more. It also helps to determine the correct histology to use within a case.   

Every few years, standard setters, like SEER, make changes to their rules to reflect the changes made by other standard setters. The changes can be minimal with just a few changes that have little effect to major changes that require a lot of time to get to know and become comfortable with prior to starting a new year of abstracting. The upcoming year, 2022, has a significant number of changes made across several manuals including the Solid Tumor Rules (STR). This manual is divided into several sections covering many different sites from the colon, kidney, lung, head and neck, and much more. During the next several articles we will cover most of the changes within each section of the Solid Tumor Rules. For a complete listing of all “September 2021 Revision History for Solid Tumor Rules,” you can refer to the following website https://seer.cancer.gov/tools/solidtumor/revisions.html. These new rules come into effect on September 1, 2021 for all new cases diagnosed January 1, 2022 and forward. 

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


New for 2022

  • New section added 
  • NOTE:  NEW HPV (p16) Rule changes: 
    • Beginning with cases diagnosed 1/1/2022 forward, p16 test results can be used to code squamous cell carcinoma, HPV positive (8085) and squamous cell carcinoma, HPV negative (8086. 

Equivalent or Equal Terms: 

  • New Terms added:
    • Squamous cell carcinoma, HPV-negative; squamous cell carcinoma, HPV-independent (8086)
    • Squamous cell carcinoma, HPV-positive; squamous cell carcinoma, HPV-associated; squamous cell carcinoma, HPV-related (8085) 

Table 1: Tumors of Nasal Cavity, Paranasal Sinuses and Skull base 
  • Non-keratinizing squamous cell carcinoma 8072 row deleted; histology moved to the subtype/variant column of the SCC row 
  • Squamous cell carcinoma 8070 row: 
    • NEW Synonyms added (See synonyms column): 
      • Squamous cell carcinoma, usual type 8070/3 
      • Conventional Squamous cell carcinoma NOS 
      • Epidermoid carcinoma, NOS 8070/3 
      • Epidermoid carcinoma in situ, NOS 8070/2 
      • Squamous carcinoma 8070/3 
      • Squamous cell carcinoma in situ, NOS 8070/2 
      • Squamous cell epithelioma 8070/3 
      • Intraepithelial squamous cell carcinoma 8070/2 
    • NEW Subtypes/variants added (See subtypes/variants column): 
      • Squamous cell carcinoma, large cell, nonkeratinizing/Squamous cell carcinoma, nonkeratinizing, NOS 8072 
      • Schneiderian carcinoma/cylindrical cell carcinoma 8121 
      • Sarcomatoid squamous cell carcinoma/spindle cell squamous cell carcinoma (SC-SCC) 8074 
    • NEW Synonyms added for keratinizing squamous cell carcinoma 8071: 
      • Epidermoid carcinoma, keratinizing 
      • Squamous cell carcinoma, large cell, keratinizing 

Table 2: Tumors of Nasopharynx 
  • Squamous cell carcinoma row 8070: 
    • NEW Subtypes/variants added (See subtypes/variants column): 
      • Lymphoepithelial carcinoma 8082 
      • Undifferentiated carcinoma/Undifferentiated carcinoma with lymphoid stroma 8020 

Table 3: Tumors of Pyriform Sinus, Hypopharynx, Larynx, Trachea, and Parapharyngeal Space 
  • Squamous cell carcinoma 8070 row: 
    • NEW Synonym added (See synonyms column): 
      • "Non-keratinizing squamous cell carcinoma 8072" added as a subtype/variant 

Table 4: Tumors of Oral Cavity and Mobile Tongue 
  • C024 Lingual tonsil removed from Table 4 and moved to Table 5 
  • NEW Synonym added (See synonyms column): 
    • Conventional Squamous cell carcinoma NOS

Table 5: Tumors of the Oropharynx, Base of Tongue, Tonsils, Adenoids 
  • C024 Lingual tonsil added to Table 5 
  • Instructions added for coding SCC HPV+ and SCC HPV- 
  • Squamous cell carcinoma row 8070: 
    • NEW Notes added: 
      • "Beginning 1/1/2022, keratinizing squamous cell carcinoma, HPV negative is coded 8086 for sites listed in Table 5 only. A diagnosis of keratinizing squamous cell carcinoma, NOS is coded 8071." 
      • "Beginning 1/1/2022, non-keratinizing squamous cell carcinoma, HPV positive is coded 8085 for sites listed in Table 5 only. A diagnosis of non-keratinizing squamous cell carcinoma, NOS is coded 8072." 
    • NEW Synonym added (See synonyms column): 
      • Conventional Squamous cell carcinoma NOS 
    • SEE NOTE Column 3, Table 5 
      • Instructions added to column 3 regarding coding SCC HPV+ and SCC HPV-

Table 6: Tumors of Salivary Glands 
  • Squamous cell carcinoma row 8070: 
    • NEW Synonym added (See synonyms column):
      • Conventional Squamous cell carcinoma NOS  

Table 10: Paired Sites 
  • Tonsil changed to "C098, C099" 

References: 

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