ALR > Disease

Entity

Data Element

Definition

Format

Valid Values

Purpose and Use

Completion Requirement

Changes

Disease

Patient Chart Number

Patient identifier code that is unique within the healthcare facility.

CHAR 10
Alpha-numeric.

Consistent with CIHI NACRS and DAD definition and format.

Uniquely identifies a patient within an RCC.  Necessary to determine a case.  Foundational to most measures and indicators.

Mandatory

Disease

Submitting Hospital Number

The MOHLTC healthcare facility that submits activity to OH-CCO.

CHAR 4
Numeric

Valid MOHLTC facility numbers only.  Same 3-digit number that is used for MIS submissions.  An additional leading zero is acceptable.

For current valid MOHLTC facility numbers, see Appendix A.

Allows the hospital organization submitting the data to be distinguished from the hospital site where the service was delivered.

Mandatory

Disease

Diagnosis Code

The primary disease site, or whatever other condition caused this patient to be registered at the healthcare facility.  Note that this is NOT the same as the Primary Problem field in NACRS. All newly diagnosed patients must have an ICD-10-CA code.  For patients diagnosed in prior years, submit this code using the ICD version in effect at that time.

Note:  This should not be used to report Cancer Diagnosis.  Topography and Morphology must be used. (Applies to RCCs only)

CHAR 7

Only valid ICD-8, -9, -9CM, or -10 codes accepted.  See Appendix 1.18 for detailed list and descriptions of ICD-10-CA.

For patients diagnosed in prior years, use the ICD version in effect at that time and submit the appropriate Diagnosis Code Version.  Effective April 1, 2008 for new cases use the ICD10CA.

Used to report activity by disease site group. Used to report incidence and mortality rates by cancer type, ALR, Wait Times, and funding.

Disease

Diagnosis Code Version

ICD version of the diagnosis code. 

CHAR 3

8 = ICD-8
9 = ICD-9
9CM = ICD-9-CM
10 = ICD-10-CA

Used for patients registered in prior years.  Allows the original diagnosis to be used in historical analyses if necessary.

Disease

Topography Code

In accordance with ICDO standards, indicates the disease site of origin of a neoplasm.  

All newly diagnosed patients must have an ICD-0-3 Topography code.  For patients diagnosed in prior years, submit this code using the ICD version in effect at that time. Topography code describing the site of the neoplasm at time of diagnosis.

CHAR 4

alphanumeric

Please refer to Appendix 1.3 .

To facilitate T, N, M validation and derivation of best stage.

Disease

Morphology Code

In accordance with ICDO coding standards,  code structure describes (4 digit) Histology (Tumour/cell type), (5th digit) Behaviour, (6th digit) Grade or Cell lineage (leukemia's).

CHAR 5

New diagnoses should use the morphology codes from ICD-O-3.  Recurrences of cancers diagnosed in prior years can be reported using whatever version of ICD-O was originally used.

Note:  Version 3 to be used for NEW registrations effective April 1, 2008

Exclude non-numeric symbols, such as slashes (/).

For 2018-2021 cases – use ICD-O-3 updated lists as referenced in Morphology Code field explanation (see Appendix 1.36).  Do not rely on the hardcopy ICD-O-3 manual.

Used for calculating incidence rates. Also used for linking, planning and Ontario Cancer Registry.

Disease

Topography/Morphology Code Version

Version of ICD-O that was used for the Topography/Morphology Code.

CHAR 2

M - MOTNAC

1 -  ICD-O-1

FT - ICD-O Field Trial (1988-92)

2 - ICD-O-2

3 - ICD-O-3

Note:  Version 3 to be used for NEW registrations effective April 1, 2008 

Used for calculating incidence rates, Ontario Cancer Registry

Disease

Basis of Diagnosis

The method used for diagnosis confirmation.

CHAR 1

See Appendix 1.23 for possible values.

Analysis of incidence and survival may be confined to micro-confirmed cases only, Ontario Cancer Registry.

Disease

Date of Initial Diagnosis

Date of initial diagnosis by a physician for this disease.  May be clinical or pathological, but should be chosen with the following priority listing:
1)  Date of first histology or cytology confirmation of malignancy (date specimen taken);  2) Date of admission to hospital, or date of first outpatient consultation.

YYYYMMDD 

Valid dates only.

If diagnosis is made at another facility and is not known, use an approximation.

Used for incidence rate calculations, Ontario Cancer Registry.

Disease

Diagnosis Hospital Number

MOHLTC Master Number and name for the reporting healthcare facility where the diagnosis was made (known by CIHI as Institution Numbers).

CHAR 4

Numeric, valid MOHLTC master numbers or NULL only.  Same as CIHI's Institution Number for NACRS submissions, but does not include CIHI's provincial identifier digit.

 For current valid MOHLTC master numbers, see Appendix A.

Used for linking patient records in the Ontario Cancer Registry.

Disease

Diagnosis Hospital Chart Number

Unique patient identifier assigned by the reporting healthcare facility (MOHLTC Master Number) where the diagnosis was made.

CHAR 10
Alpha-numeric.

Consistent with CIHI NACRS and DAD definition and format.

Used for linking patient records in the Ontario Cancer Registry.

Disease

Patient Postal Code at  Diagnosis

Patient’s postal code of their home address on the date of diagnosis.

CHAR 10

Canadian postal codes must be in the format ANANAN (no space), where A is a letter and N is a number.  For US zip codes, use either NNNNN or NNNNN-NNNN. CIHI’s two-letter province/state codes are also acceptable if full code not known or for non-Canadian residence. See Appendix B. 

Used for generating incidence rates by geographic region, and for registry linking,Planning, Ontario Cancer Registry

Mandatory

Disease

Registration Date

Date this patient was first registered at this RCC and/or hospital for this disease

YYYYMMDD 

Valid dates only.

Date must be equal to or before patient's first visit at this centre for this disease.

Used as a surrogate for date of initial diagnosis when date of initial diagnosis in not available. Additional purpose: Used to derive disease sequence number for sites who do not submit the disease sequence number. Therefore used to link clinic visit activity to patient’s disease.

Mandatory

Disease

Disease Sequence Number

The numeric sequence assigned to a primary cancer for a patient at a specific healthcare facility.

INTEGER

1 through 99.

When combined with a patient identifier, disease sequence number uniquely defines a cancer case.

Disease Sequence Number must be either entered or left blank on ALL records in ALL entities from a submitting site, and that must remain consistent from month to month.

If left blank, OH-CCO will derive a value from the Registration Date.  If this is the case, the field must be unique amongst Diseases within the Patient.

Used in ALR, Ontario Cancer Registry, Wait Times, Planning, and funding.

Disease

Clinical Stage at Diagnosis

The extent or severity of the cancer at the time of diagnosis most recently reported by clinicians before cancer surgery has been performed.

CHAR 15

See Appendix 1.9 for OH-CCO Cancer Staging Policy and AJCC website.

e.g. 2A or 2 .

If Clinical Stage at Diagnosis is present, then Topography and Morphology Code should not be Null.

Used to comply with OH-CCO staging policy. Concordance with evidence-based practice guidelines.  Disease staging report.  Ontario Cancer Registry.

Disease

Clinical Stage, T Category at Diagnosis

The extent of the primary tumour reported by clinicians before cancer directed surgery has been performed; submitted during the first 6 months after visiting a RCC.

CHAR 15

See Appendix 1.9 for OH-CCO Cancer Staging Policy and AJCC website. 

e.g. TX, T1, T1a, etc

Used to comply with OH-CCO staging policy. Concordance with evidence-based practice guidelines.  Disease staging report.  Ontario Cancer Registry.

Disease

Clinical Stage, T Suffix  at Diagnosis

Detailed site-specific codes for the clinical T category suffix as defined by AJCC and recorded by the physician.

CHAR 1

m–multiple synchronous tumours or for thyroid differentiated and anaplastic only, Multifocal tumour

s–for thyroid differentiated and anaplastic only, Solitary tumour

blank–no information available; not recorded

Vital for evaluation of cancers within the affected AJCC schema.

Disease

Clinical Stage, N Category at Diagnosis

The absence or presence and extent of regional lymph node metastasis reported by clinicians before cancer surgery has been performed; submitted during the first 6 months after visiting a RCC.

CHAR 15

See Appendix 1.9 for OH-CCO Cancer Staging Policy and AJCC website. 

e.g. NX, N0, N1, N1a

Used to comply with OH-CCO staging policy. Concordance with evidence-based practice guidelines.  Disease staging report.  Ontario Cancer Registry.

Disease

Clinical Stage, N Suffix at Diagnosis

Detailed site-specific codes for the clinical N category suffix as defined by AJCC and recorded by the physician.

CHAR 2

sn–sentinel node procedure without resection of nodal basin

f–FNA or core needle biopsy without resection of nodal basin

blank–no suffix needed or appropriate; not recorded

Vital for evaluation of cancers within the affected AJCC schema.

Disease

Clinical Stage, M Category at Diagnosis

The absence or presence of distant metastasis reported by clinicians before cancer directed surgery has been performed; submitted during the first 6 months after visiting a RCC.

CHAR 15

See Appendix 1.9 for OH-CCO Cancer Staging Policy and AJCC website. 

e.g. MX, M0, M1, M1a

Used to comply with OH-CCO staging policy. Concordance with evidence-based practice guidelines.  Disease staging report.  Ontario Cancer Registry.

Disease

Pathological Stage at Diagnosis

Pathologic Staging is applied to cases where surgery was completed to remove or explore the extent of the cancer. Stage data at the time of diagnosis reported by a pathologist after cancer surgery.

CHAR 15

See Appendix 1.9 or OH-CCO Cancer Staging Policy and AJCC website.

e.g. 2A or 2 .

If Pathological Stage at Diagnosis is present, then Topography and Morphology Code should not be Null.

Used to comply with OH-CCO staging policy. Concordance with evidence-based practice guidelines.  Disease staging report.  Ontario Cancer Registry.

Disease

Pathological Stage, T Category at Diagnosis

The extent of the primary tumour reported by a pathologist after cancer directed surgery has been performed.

CHAR 15

See Appendix 1.9 for OH-CCO Cancer Staging Policy and AJCC website.

e.g. TX, T1, T1a, etc

Disease

Pathological Stage, T Suffix at Diagnosis

Detailed site-specific codes for the pathological T category suffix as defined by AJCC and recorded by the physician.

CHAR 1

m–multiple synchronous tumours or for thyroid differentiated and anaplastic only, Multifocal tumour

s–for thyroid differentiated and anaplastic only, Solitary tumour

blank–no information available; not recorded

Vital for evaluation of cancers within the affected AJCC schema.

Disease

Pathological Stage, N Category at Diagnosis

The absence or presence and extent of regional lymph node metastasis reported by a pathologist after cancer surgery has been performed.

CHAR 15

See Appendix 1.9 for OH-CCO Cancer Staging Policy and AJCC website.

e.g. NX, N0, N1, N1a

Used to comply with OH-CCO staging policy. Concordance with evidence-based practice guidelines.  Disease staging report. Ontario Cancer Registry.

Disease

Pathological Stage, N Suffix at Diagnosis

Detailed site-specific codes for the pathological N category suffix as defined by AJCC and recorded by the physician.

CHAR 2

sn–sentinel node procedure without resection of nodal basin

f–FNA or core needle biopsy without resection of nodal basin

blank–no suffix needed or appropriate; not recorded

Vital for evaluation of cancers within the affected AJCC schema.

Disease

Pathological Stage, M Category at Diagnosis

The absence or presence of distant metastatic reported by a pathologist or other physician the finding may be clinical or pathologic after cancer surgery has been performed”

CHAR 15

See Appendix 1.9 for OH-CCO Cancer Staging Policy and AJCC website.

e.g. MX, M0, M1, M1a

Used to comply with OH-CCO staging policy. Concordance with evidence-based practice guidelines. Disease staging report. Ontario Cancer Registry.

Disease

Post Therapy Stage

Detailed site-specific codes for the post neoadjuvant therapy stage group as defined by AJCC and recorded by the physician.

Note: this is the Pathologic post-neoadjuvant therapy stage.  The patient must go on to have surgery after neoadjuvant therapy - as part of first course treatment - for this stage to be valid.

CHAR 15

See Appendix 1.9 for OH-CCO Cancer Staging Policy and AJCC website.  e.g. 0, 0a, 0is, 1, etc.

Identifies the remaining anatomic extent of disease based on the T and N following the completion of neoadjuvant therapy (satisfying the definition for that disease site) and planned post neoadjuvant therapy surgical resection, and the M status defined during the diagnostic workup. This new staging dimension has become a mandatory part of the AJCC 8th edition system for relevant cases.  It is necessary to collect this information to remain compliant with AJCC rules.

Disease

Post Therapy Stage, T Category

Detailed site-specific codes for the post neoadjuvant therapy tumor (T) as defined by AJCC and recorded by the physician.

CHAR 15

See Appendix 1.9  for OH-CCO Cancer Staging Policy and AJCC website.  e.g. 0, 0a, 0is, 1, etc.

Evaluates the primary tumor (T) and reflects the tumor size and/or extension of the tumor known following the completion of neoadjuvant therapy (satisfying the definition for that disease site) and planned post neoadjuvant therapy surgical resection. This new staging dimension has become a mandatory part of the AJCC 8th edition system for relevant cases.  It is necessary to collect this information to remain compliant with AJCC rules.

Disease

Post Therapy Stage, T Suffix

Detailed site-specific codes for the post neoadjuvant therapy T category suffix as defined by AJCC and recorded by the physician.

CHAR 1

m–multiple synchronous tumours or for thyroid differentiated and anaplastic only, Multifocal tumour

s–for thyroid differentiated and anaplastic only, Solitary tumour

blank–no information available; not recorded

Vital for evaluation of cancers within the affected AJCC schema.

Disease

Post Therapy Stage, N Category

Detailed site-specific codes for the post neoadjuvant therapy nodes (N) as defined by AJCC and recorded by the physician.

CHAR 15

See Appendix 1.9 for OH-CCO Cancer Staging Policy and AJCC website.  e.g. 0, 0a, 0is, 1, etc.

Identifies the absence or presence of regional lymph node (N) metastasis and describes the extent of lymph node metastasis of the tumor known known following the completion of neoadjuvant therapy (satisfying the definition for that disease site) and planned post neoadjuvant therapy surgical resection. This new staging dimension has become a mandatory part of the AJCC 8th edition system for relevant cases.  It is necessary to collect this information to remain compliant with AJCC rules.

Disease

Post Therapy Stage, N Suffix

Detailed site-specific codes for the post neoadjuvant therapy N category suffix as defined by AJCC and recorded by the physician.

CHAR 2

sn–sentinel node procedure without resection of nodal basin

f–FNA or core needle biopsy without resection of nodal basin

blank–no suffix needed or appropriate; not recorded

Vital for evaluation of cancers within the affected AJCC schema.

Disease

Post Therapy Stage, M Category

Detailed site-specific codes for the post neoadjuvant therapy category metastases (M) as defined by AJCC and recorded by the physician.

CHAR 15

See Appendix 1.9 for OH-CCO Cancer Staging Policy and AJCC website.  e.g. 0, 0a, 0is, 1, etc.

M category for post neoadjuvant therapy staging remains the same as that assigned in the clinical stage before initiation of neoadjuvant therapy, cM or pM. This new staging dimension has become a mandatory part of the AJCC 8th edition system for relevant cases.  It is necessary to collect this information to remain compliant with AJCC rules.

Disease

Staging Version

Version of the AJCC TNM staging manual used for staging this disease.

AJCC 7th Edition (07) or (FF) must be used for all diseases registered on or after Jan. 1, 2011.

AJCC 8th Edition (08) or (FF) must be used for all diseases registered on or after Jan. 1, 2019.

Note:   Staging Version 09 will be applicable to specific protocols (formerly “chapters”),

as released by AJCC over the years (starting Jan. 1, 2021).

CHAR 2

06 - AJCC 6th Edition

07 - AJCC 7th Edition

FF - FIGO  (per AJCC 6th)

08 – AJCC 8th Edition

09 - AJCC 9th Edition

Identifies the staging version that was used for this patient.   Current cases should be staged using version 06, but those staged in prior years may have used an earlier version. FIGO  code added to identify Gynecology related Stage capture

Disease

Analytic Flag

Identifies a neoplastic case, whether it is reportable to the OCR, and if it qualifies for stage analysis.

CHAR 1

0 = Class of case Unknown/Reason for referral

0 = Non-reportable disease

1 = Analytic Case

2 = Non Analytic Case

9 - There is not enough information at this time to choose values 0, 1 or 2.

See Appendix 1.16

To identify the reason the case was referred to the RCC

Disease

Date of Referral to a Medical Oncologist

The date on which a request (fax/phone call) for consultation with a Medical Oncologist is received at the Regional Cancer Centre/hospitals from the referring physician.  Note:  Date of Fax received over the weekend to be used (ie. date of following business day not to be used)

YYYYMMDD 

Valid dates only.

Calculation of wait times by program.

Wait Times reports

Disease

Date of Referral to a Radiation Oncologist

The date on which a request (fax/phone call) for consultation with a Radiation Oncologist is received at the Regional Cancer Centre/hospitals from the referring physician. Note:  Date of Fax received over the weekend to be used (ie. date of following business day not to be used)

YYYYMMDD 

Valid dates only.

Calculation of wait times by program.

Wait Times reports

Disease

Date of Referral to a Surgical Oncologist

The date on which a request (fax/phone call) for consultation with a Surgical Oncologist is received at the Regional Cancer Centre/hospitals from the referring physician. Note:  Date of Fax received over the weekend to be used (ie. date of following business day not to be used)

YYYYMMDD 

Valid dates only.

Calculation of wait times by program.

Wait Times reports

Disease

Date of Referral to Palliative Care Program

The date on which a request (fax/phone call) for consultation with a Palliative Care Clinician is received at the Regional Cancer Centre/hospital from the referring clinician. Note:  Date of Fax received over the weekend to be used (i.e. date of following business day not to be used)

YYYYMMDD

Valid dates only

Calculation of wait times by program.

Disease

Date of Referral to Social Work

The date on which a request for consultation to a Social Worker is received at the Regional Cancer Centre/hospital. Note:  Date of referral received over the weekend to be used (i.e. date of following business day not to be used)

YYYYMMDD

Valid dates only.

Calculation of wait times by program

Disease

Date of Referral to Dietitian

The date on which a request for consultation to a Dietitian is received at the Regional Cancer Centre/hospital. Note:  Date of referral received over the weekend to be used (i.e. date of following business day not to be used)

YYYYMMDD

Valid dates only.

Calculation of wait times by program

Disease

Date of Referral to Physiotherapy

The date on which a request for consultation to a Physiotherapist is received at the Regional Cancer Centre/hospital. Note:  Date of referral received over the weekend to be used (i.e. date of following business day not to be used)

YYYYMMDD

Valid dates only.

Calculation of wait times by program

Disease

Date of Referral to Psychiatry

The date on which a request for consultation to a Psychiatrist is received at the Regional Cancer Centre/hospital. Note:  Date of referral received over the weekend to be used (i.e. date of following business day not to be used) 

YYYYMMDD

Valid dates only.

Calculation of wait times by program

Disease

Date of Referral to Psychology

The date on which a request for consultation to a Psychologist is received at the Regional Cancer Centre/hospital. Note:  Date of referral received over the weekend to be used (i.e. date of following business day not to be used)

YYYYMMDD

Valid dates only.

Calculation of wait times by program

Disease

Date of Referral to Occupational Therapy

The date on which a request for consultation to an Occupational Therapist is received at the Regional Cancer Centre/hospital. Note:  Date of referral received over the weekend to be used (i.e. date of following business day not to be used).

YYYYMMDD

Valid dates only.

Calculation of wait times by program

Disease

Date of Referral to Speech Language Pathology

The date on which a request for consultation to a Speech Language Therapist is received at the Regional Cancer Centre/hospital. Note:  Date of referral received over the weekend to be used (i.e. date of following business day not to be used).

YYYYMMDD

Valid dates only.

Calculation of wait times by program

Disease

Laterality

Identifies the side of a paired organ or the side of the body on which the reportable tumour originated.  This applies to the primary disease site only.

See STORE manual, page 135

CHAR 1

0  Organ is not considered to be a paired side.

1  Origin of primary is right.

2  Origin of primary is left.

3  Only one side involved, right or left origin not specified.

4  Bilateral involvement, side of origin unknown, stated to be a single primary.

5  Paired site: midline tumor

9  Paired site, but lateral origin unknown;

To capture laterality because ICD-O-3 Topography codes do not.

See Appendix 1.3 for topography list with laterality values.  Note: Laterality often supports determination of multiple primaries.