Staging and Coding, Research Paper Example

Introduction

Cancer staging concepts describe the classification of the cancer disease based on how far the cancerous cells have affected the body from the time they have first diagnosed, what healthcare practitioners define as the extent of cancer. The cancer stages are described in terms of the tumor size in which the cancer cells invade the body organ, the extent of the spread for metastasis, and the closeness to the lymph nodes (Chen & Weng, 2021). Physicians in the sector depend on cancer staging to help develop cancer treatment plans, predict the patient outlook for prognosis, indicate the health intervention and how it will work, and create clinical trials for healthcare research. Three well-recognized cancer staging systems used the eighth edition of the AJCC, SEER EOD, and SEER Summary Staging systems (Chen & Weng, 2021). In this essay, the assignment will explore the similarities, differences, importance, abstracts, and development of these coding systems. The three cancer coding systems use two primary staging and coding systems that help physicians during cancer diagnosis and intervention recommendation, the tumor’s size, the spread in the lymph nodes, and the tumor grade.

Development, Monitoring, and Abstract from Cancer Coding Systems

The summary staging coding system is based on the theory of cancer growth, also known as general staging. The system is the most basic staging system that depends on the patient’s medical history and clinical and pathological data, which stages the tumor into a registry (Chen & Weng, 2021). The main limitation of this coding system is that the detailed analysis by the physician of different cases is sometimes not possible. The SEER summary staging system initially began in 1988, developed by NAACCR but has undergone several revisions (Kim et al., 2017). In addition, the SEER EOD developed in 2003 describes the set of three data items that represent the extent to which cancer has spread from the time of diagnosis. The coding system was designed to assist the central registry in consolidating the EOD data items from EOD primary tumor, regional nodes, and Mets based on the eighth edition from AJCC. Furthermore, the AJCC was developed in 1959 under the AJC for SEER by the IUAC. Later in 1977, the coding system changed to AJCC (Keung & Gershenwald, 2018). The coding system classifies the cancer cell’s invasion by scope and degree of the primary growth, connection and association with the lymph nodes, and the manifestation and absence of metastases. The NCI monitors the three cancer staging systems, part of the NIH, among the eleven agencies from the department of health in the USA.

Similarities for Cancer Coding Systems

The three cancer coding systems are not significantly different compared to each other as they all classify the extent of cancer invasion in the body by using three data registries the primary tumor, regional nodes, and the Mets invasion (Kim et al., 2017). When the physician first diagnoses the patient with cancer, the help from these three cancer coding systems helps the physician understand how serious the disease is to estimate the chances of survival for the patient, plan for the best intervention, and identify clinical trials. SEER Summary Staging, EOD, and AJCC help the physician locate the tumor in the body after diagnosis, the type of cell invaded, such as adenocarcinoma, the tumor’s size, and the spread in the lymph nodes, and the tumor grade (Kim et al., 2017). For example, when the physician diagnoses the patient with cancer, there are letters and numbers assigned to the diagnosis, such as T1N0MX, which all have meanings to help the physician interpret in recommending intervention and survival chances. In this example, T1 shows that the tumor size is small. The higher the number, the larger the tumor, such as T3 or T4. N0 shows that the location in the lymph nodes is nowhere near the affected cells. The higher the number, the more lymph nodes are affected, such as N2 or N3. Finally, the distant metastasis also describes the spread; MX shows the spread cannot be measured M1 because the metastasis has spread to other body parts.

Differences in Cancer Coding Systems

The three coding systems are not entirely the same as mentioned in the way they operate as the AJCC states the primary sites in the body where cancer has invaded, which the physician interprets in a more detailed manner, while the SEER summary staging and EOD systems only list the major category sites and subsets for the cancer cells (Kim et al., 2017). The summary stage forms the fundamental way physicians categorize the extent of the cancer cells spread from the point of origin for cancer, while the EOD describes to the physician the spread of cancer from the time of diagnosis. The physician had few details on how best to recommend intervention for the cancer patient in the past. In this regard, physicians widely use the AJCC coding system (Kim et al., 2017). Apart from identifying the origin and spread of the cancer cells, the AJCC cancer coding system allows the physician to recommend the best and appropriate intervention to the patient from the prognosis assessment and a continuous evaluation for cancer control measures (Keung & Gershenwald, 2018). The eighth edition for the AJCC describes the compendium of all databases run for cancer registries providing physicians with readily available cancer information for staging cancer using all general clinically meaningful anatomic sites.

Coding Systems Type for Staging

The other difference between the cancer staging code systems is that SEER EOD and Summary Stage systems use the clinical coding system, which bases the diagnosis argument by the physician on the patient medical history (Kim et al., 2017). On the other hand, AJCC uses the pathological coding system that helps the physician gather additional information when examining the tumor, expressing the cancer stages before the physician recommends the appropriate intervention (Keung & Gershenwald, 2018). While clinical staging helps the therapist plan for the treatment, the pathological staging used in AJCC helps the therapist understand the prognosis for the patient to discover the treatment pathway that works best for the patient. In addition, the SEER EOD and Summary staging depend on the patient medical history in diagnosing cancer, while AJCC requires additional information collected, such as prognosis information, intervention plan, and treatment pathways adopted by the physician.

Conclusion

In summary, physicians use three cancer coding systems that describe the classification of the cancer disease based on how far the cancerous cells have affected the body from the time they have first diagnosed, what healthcare practitioners define as the extent of cancer. These three cancer staging systems used the eighth edition of the AJCC, SEER EOD, and SEER Summary Staging systems. The AJCC, initially developed in 1959 by IUAC, later changed its name in 1977, classifies the cancer cell’s invasion by scope and degree of the primary growth, connection and association with the lymph nodes, and the manifestation and absence of metastases. In addition, the SEER Summary Staging system initially began operations in 1988, with the EOD developed later in 2003, describing the set of three data items that represent the extent to which cancer has spread from the time of diagnosis. The two systems were initially developed and monitored by NAACCR and later NCI. Furthermore, the cancer coding system was designed to assist the central registry in consolidating the EOD data items from EOD primary tumor, regional nodes, and Mets based on the eighth edition from AJCC.

References

Chen, Y., & Weng, S. (2021). Reappraisal of the T Category for Solitary Intrahepatic Cholangiocarcinoma by Tumor Size in 611 Early-Stage (T1-2N0M0) Patients After Hepatectomy: A Surveillance, Epidemiology, and End Results (SEER) Analysis. Journal of Gastrointestinal Surgery, 25(8), 1989-1999. https://doi.org/10.1007/s11605-020-04833-x

Keung, E. Z., & Gershenwald, J. E. (2018). The Eighth Edition American Joint Committee on Cancer (AJCC) Melanoma Staging System: Implications for Melanoma Treatment and Care. Expert Review of Anticancer Therapy, 18(8), 775-784. https://dx.doi.org/10.1080%2F14737140.2018.1489246

Kim, Y., Moris, D. P., Zhang, X. F., Bagante, F., Spolverato, G., Schmidt, C., … & Pawlik, T. M. (2017). Evaluation of the 8th Edition American Joint Commission on Cancer (AJCC) Staging System for Patients with Intrahepatic Cholangiocarcinoma: A Surveillance, Epidemiology, and End Results (SEER) Analysis. Journal of Surgical Oncology, 116(6), 643-650. https://doi.org/10.1002/jso.24720