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SEER Training Modules

Review of General Information for Determining Multiple Primaries

Note: The rules do not apply to hematopoietic primaries (lymphoma and leukemia) of any site or to the reportable benign or borderline intracranial or CNS tumors.

A. General Information

  1. Use these rules to determine the number of reportable primaries. Do not use these rules to determine case reportablility, stage, or grade. To review the discussion, go to When & How to Use the New Rules Section 3.
  2. The 2007 multiple primary and histology coding rules replace all previous multiple primary and histology coding rules. To review the discussion, go to Overview: What The 2007 Rules Are and Major Changes.
  3. The rules are effective for cases diagnosed January 1, 2007 and after. Do not use these rules to abstract cases diagnosed prior to January 1, 2007. To review the discussion, go to Overview: What The 2007 Rules Are and Major Changes.
  4. Read the General Instructions and the site-specific Equivalent Terms and Definitions before using the multiple primary rules. To review the discussion, go to When & How to Use the New Rules and Equivalent Terms.
  5. The multiple primary and histology coding rules are available in three formats: flowchart, text, and matrix. The rules are identical, only the formats differ. Use the rules in the format that is easiest for you to follow. To review the discussion, go to Formats.
  6. Notes and examples are included with some of the rules to highlight key points or to add clarity to the rules. To review the discussion, go to When & How to Use the New Rules Section 5.
  7. Do not use a physician's statement to decide whether the patient has a recurrence of a previous cancer or a new primary. Use the multiple primary rules as written unless a pathologist compares the present tumor to the "original" tumor and states that this tumor is a recurrence of cancer from the previous primary. To review the discussion, go to Definitions.
  8. Use the Determining Multiple Primaries: Hematopoietic Primaries (Lymphoma and Leukemia) rules and table "Definitions of Single and Subsequent Primaries for Hematologic Malignancies" to determine single versus multiple primaries for lymphoma and leukemia cases. To review the discussion, go to When & How to Use the New Rules Section 2.