• ICD-O-3 topography codes
    ICD-O-3 topography codes do not provide sufficient detail to specify the many sub sites for skin melanoma.

Laterality-related issues

  • Right/left/midline
    The regional lymph node drainage of the melanoma site contributes to determining single or multiple primaries. This issue is not addressed in the existing rules.
  • Front/back
    Similarly, regional lymph node drainage of a melanoma site on the front or back of the body may be different, and this issue is not addressed in the existing rules.

Histology issues

  • Precancerous lesions
    Terminology describing precancerous lesions is a source of great confusion for registrars doing casefinding. For example, the following terms are not reportable to SEER, NPCR or CoC: atypical melanocytic hyperplasia, Melanocytic intraepithelial neoplasia, or evolving melanoma
  • In situ melanoma
    When do certain terms refer to in situ melanoma?
  • In situ and invasive melanoma
    How are combinations of behavior abstracted and coded?
  • Histology codes
    Are there priorities to coding histology and counting multiple primaries for various types of melanomas?

Other issues

  • Time between diagnoses
    For melanomas that reappear in the same primary site, is the existing two-month rule sufficient?
  • Regressing melanoma
    Regressing melanoma has some unique coding problems, and some have been missed in the past
  • Effect on incidence counts and rates
    Changing the multiple primaries rules will have to be done very carefully so that an epidemic of melanoma is not artificially created when we compare pre-2007 melanoma rates to 2007 and forward rates