What is Collaborative Stage (CS)?

Cancer stage historically has been collected using three different staging systems having three different purposes, data sets and rules. The American Joint Committee on Cancer (AJCC), in collaboration with North American standards setters, has developed a unified data set that will combine and standardize the information needed to assign stage in the AJCC (TNM), SEER (EOD) and Summary Stage (SS) 1977 and 2000 systems and to derive the T, N, M, stage group, Extent of Disease (EOD), and SS applicable to each cancer site. Collaborative Stage (CS) allows combined pathological and clinical "mixed" or "best" stages to be captured. Additional data elements have been incorporated into the CS data set to support and enhance the description of the cancer stage.

Collaborative Stage provides the advantages of a unified data collection system designed to provide a common goal and meet all the needs of the three staging systems, TNM, EOD, SS. It also provides a comprehensive system to improve data quality by standardizing rules for timing, clinical and pathologic assessments, and compatibility of descriptions across all of these systems for all cancer sites.

The Commission on Cancer (CoC) approvals program will require that the registrar record the T, N, M and stage groups as the physician has documented them in the medical record. This will enable comparison of CS and physician's stage and allow the CoC to assess the need for physician education in staging.

Cancer Stage System Collaborators

• AJCC: American Joint Committee on Cancer
• ACoS/CoC: American College of Surgeon Commission on Cancer
• NCRA: National Cancer Registrars Association
• NCI/SEER: National Cancer Institute/SEER Program
• CDC/NPCR: Centers for Disease Control and Prevention/National Program of Central Registries
• NAACCR: North American Association of Central Cancer Registries
• CCCS: Canadian Council on Cancer Staging

Figure 1 shows the true collaboration between agencies involved in cancer data collection to create a system that will allow the different staging systems to join together—as ONE!

View the slide illustrating The Collaborative Staging system.

Visit the AJCC Collaborative Staging info Web page.

AJCC Collaborative Stage Manual is available in PDF format:

• Part One (PDF)
• Part Two (PDF)
• Site-Specific Schema and Coding Instructions
• Histology Schemas and Coding Instructions