Message from SEER and NAACCR

July 17, 2019
Solid Tumor Rules: July 2019 Update

Based on questions and continued suggestions from registrars and educators, the decision was made to update the applicable rules at this time. Most changes are minor: terminology, additional definitions, and new notes and examples.   We recommend you read the July 2019 Change Log to understand what changes were made. 

Major changes
Lung H rule:

We identified an issue with lung histology reporting by pathologists and after consulting with our expert lung pathologist, determined that a rule should be added to specifically address this issue.  

The new lung H rule address tumors with multiple types of adenocarcinoma and percentages of each type listed in the diagnosis. The original H rule instructed registrars to code adenocarcinoma, mixed types (8255/3). Per our lung expert, ICD-O code 8255/3 is strongly discouraged. The new H rule provides instructions on coding the histology comprising the greatest percentage of tumor. Lung Table 2 (Combination histology codes) has also been updated to reinforce the new H rule. 

Important:  We strongly suggest you review lung cases diagnosed 1/1/2018 forward with code 8255/3 to determine if a specific histology code can be assigned based on the new H rule. By coding a specific histology rather than the mixed histology, you will be able to assign stage.  

Lung M rule:
A rule was added to address separate non-contiguous tumors, one with a combination code from Table 2 and one with a single histology from Table 3.

A comprehensive change log has also been posted for reference. 

The updated rules published July 2019 apply to the following sites only:

•       Breast
•       Colon/Rectum
•       Head & Neck 
•       Lung
•       Kidney
•       Malignant CNS
•       Non-malignant CNS
•       Urinary

The Solid Tumor Manual can be accessed at:

Submit questions concerning the Solid Tumor Rules to Ask A SEER Registrar:

2019 Events in Arizona

2019 Events in Arizona

  • Arizona Cancer Registry will be hosting an Annual Workshop, A Data Focus, on June 28th, 2019 at Desert Willow Conference Center. 

  • Cancer Registrar of Arizona (CRAAZ) will be hosting an Annual Event on November 20th, 2019 at St Joseph Hospital & Medical Center in Phoenix Arizona.

  • American Cancer Society will be hosting several events in Arizona.  Here are a list of events if you would like to attend. If you would like additional information on any of these events click here to search for that specific event. 
    • 2019 Tucson DE Breakfast AZ
    • 2019 Real Men Wear Pink of Phoenix AZ
    • 2019 Relay For Life of Queen Creek and San Tan Valley AZ VL
    • 2019 Making Strides of Phoenix AZ
    • 2019 Rugged Maniac Phoenix-Glendale AZ
    • 2019 OdySea in the Desert AZ

CRAAZ Conference Registration

Hello Everyone!

Registration for the Fall Conference has opened and we are ready to accept registration! Please click the link which will take you to the page to complete registration. You can either complete it online or you can print off the form and mail it to us. We will also accept late registration at the door but please complete the form early so we can adequately plan for the number of attendees! Thanks so much for all you do and we look forward to seeing you all there!

Click here to go to the registration page.

Juliet Wilkins
2018 CRAAZ President

Summertime Madness

We’ve almost made it out of summertime in Phoenix, but what has been hotter than the summer sun are some of ACR’s most recent reports available to you and the Arizona community. Still warm from the printing press; check out Arizona Melanoma Reporting 2018-1, for the most recent update on
physician reporting of melanoma. It’s hard to believe that 2018 changes are among us. At the ACR we are not only preparing for 2018 changes, but also producing information retrospectively on prior diagnosis years such as the release of “Cancer in Arizona – Statistics & Trends.” From day to day work activities, it might be hard to imagine your role in Arizona’s public health system as a single hospital registrar. However, collectively registrars have an enormous impact on cancer analysis through their abstracts. I encourage you to see the impact you make by checking for newly posted information on cancer and related at the ACR website

Kaleb Martorana
CRAAZ Secretary

Hello From Liz Pulcini

         Greetings, fellow registrars and CRAAZ members! I am relatively new to the cancer registry community, and I’d like to share what drew me to the field and where I currently am in this new career. Years ago, I had aspirations of contributing to cancer research and helping solve a small piece of the puzzle by studying mutated tumor suppressor p53 protein and its association with heat shock proteins in breast cancer cells. As a graduate student in cancer biology, I found molecular research with cancer cells interesting and challenging, but I couldn’t see myself as a principal investigator. Not many women were researchers in academia, and the few I knew were stressed trying to make it work. My ideal career had to have more flexibility. I didn’t want to do experiments in the lab every weekend or write grants during my free time.
            I moved on to more graduate studies, this time in scholarly editing, and worked as an academic copy editor for over a decade, fine tuning authors’ manuscripts to transform textbooks, journal articles, and other written works into publishable shape. The work was enjoyable and flexible, but the deadlines were challenging. The project-based nature of the work made advancement elusive, and I became stuck.
              In 2016, I began to search for a new career, one where I could use my knowledge of cancer biology and my experience with managing details as a copy editor. “Oncology Data Specialist” was the term that caught my attention. Had I found my professional niche at last?  I read about NCRA and discovered that cancer registry work seemed to pull together many of my interests and skills. I could still make a contribution to cancer research without having to DO research. I could use my editorial attention to detail to create excellent abstracts. I could work remotely. I started the online certificate program offered by NCRA/AHIMA a little over a year ago. Through extreme luck, I was connected to Juliet Wilkins (our fearless CRAAZ leader) via the NCRA mentoring program, and I could not have asked for a smarter, kinder, or more patient person to guide me through these early stages of development into a cancer registrar. If you are new to the field, I highly recommend finding a mentor. The manuals are not always clear, and it helps to have someone with experience explain and clarify certain rules and exceptions. Last October I attended my first CRAAZ meeting and met Juliet in person. I also met the registrars at Tucson Medical Center (TMC) and learned that one of them was retiring.
           Fast-forward to July 2018 and I’ve been working at TMC for about 8 months, performing all the functions of a CTR. Juliet was right, the learning curve is steep. I’m still on it. Analytical thinking and attention to detail are crucial, and my prior work prepared me well for these aspects. Staging isn’t as difficult as I expected because of my familiarity with the progression of cancer. One particular challenge for me, however, has been learning to decipher the clinical language used in operative reports. I do feel that I have found my niche though, and I am enjoying piecing together the story of each case and striving to assemble the most thorough and accurate abstracts I can.
I look forward to getting to know more of you and learning how you got into registry work and who helped you along the way. I want to hear about what’s going well in your work and what isn’t. How can we improve our abstracting, combine our intellectual resources, be more efficient, and support one another? This is part of CRAAZ’s mission. The more we collaborate, the stronger our work and our registry community will be. And a stronger registry community translates into high-quality data and better outcomes for cancer patients—our raison d’être.
Liz Pulcini, MS, General Membership Representative

Hello Arizona Registry Community!!!!!!

So happy to find you here! The Cancer Registry Association of Arizona is very excited about the new look and energy we are creating around YOUR Association. I emphasize YOUR Association because that’s what CRAAZ is. CRAAZ does not exist without the membership of the registrars throughout the state. An organization that was created in 1997 to serve the Arizona registry community in training and education, networking, and advocacy. With the busyness of the work we do and the volunteer nature of the CRAAZ Board, we recognized that CRAAZ needed to step up and be more of a presence and greater service to the AZ registry community. In the next year you will see more postings to the website… job postings… training and education opportunities… invitations for your involvement… networking opportunities… and more.

To begin with… the next NAACCR Webinar is 6/7/2018 and the topic is Thyroid and Adrenal Gland

(See the calendar attached.) Please join me at the Arizona Cancer Registry for the free airing of this webinar and gain 3 CEU’s. Watch for the registration link from survey monkey or contact Teri Johnson at

Also Please Save the Date of June 29th for the Annual Arizona Cancer Registry meeting

Please spread the word that CRAAZ is here and working to support the Arizona Registry Community. If you have not joined or know new registrars that don’t know about CRAAZ share the info and help make CRAAZ stronger and better to continue to support the good work we all do. We’re stronger together!

Teri Johnson

Trainer/CRAAZ Treasurer

Arizona Cancer Registry

NAACCR 2017-2018 Series

2018 CRAAZ Membership: The Final Countdown!


Hello, Lovelies:

Just a reminder that today is the last day to join CRAAZ for 2018, if you are so inclined.

The reason the membership period is so short is so that we can make plans for the fall meeting (it is helpful to know what your budget is if you want to secure a location and book speakers…you know, little details like that!).

You guys know the drill. You can become a CRAAZ member by:

1) Joining online via the website. I decided that revamping the website was a priority this year, so I hope you think it’s shiny. You don’t even have to be a PayPal member to pay via PayPal. When you check out, you can select pay via Debit/Credit card as an option and check out as a guest. The website page is located at

2) You can print out the membership form and mail it in along with a check for your $35 dues ($25+$10 late fee) to the CRAAZ PO Box.

Why join CRAAZ in 2018?

Well, it saves you money if you’re planning to come to our Fall 2018 educational conference.

When is that conference going to be?

I am pleased to announce that to you right now:

FRIDAY OCTOBER 19th, 2018. Stay tuned for details. Same Bat Time. Same Bat Channel.

Mark those calendars. Have you marked them????

I know I like saving money on conferences! Why else? We are stronger together, and you have access to a whole community of registrars right here. Plus all the education that goes along with being around registrars. That’s pretty priceless. Especially this year, because, well, CHANGE, CHANGE, CHANGE…

If you wait until tomorrow, we would love to have you as a member (for 2019).

Juliet Wilkins
2018 CRAAZ President

Official Proclamation from Arizona Governor Douglas A. Ducey




WHEREAS, cancer registrars help health care professionals better meet the needs of patients with cancer by collecting and maintaining data on people diagnosed with this disease; and

WHEREAS, data collected by cancer registrars is used by physicians to monitor treatment and continuing care of patients, and by epidemiologists to track the cancer activity throughout Arizona and the nation; and

WHEREAS, cancer registrars in Arizona are committed to promoting the latest medical advances in the diagnosis and treatment of cancer; and

WHEREAS, National Cancer Registrars Week recognizes the contributions that professional cancer registrars make to the field of allied health with the theme “Cancer Registrars: Hidden Jewels of Cancer Care.”

NOW, THEREFORE, 1, Douglas A. Ducey, Governor of the state of Arizona, do hereby designate April 9 – 13, 2018, as


IN WITNESS WHEREOF, 1 have hereunto set my hand and caused to be affixed the Great Seal of the State of Arizona

Douglas A. Ducey


DONE at the Capitol in Phoenix on this thirtieth day of March in the year Two Thousand and Eighteen and of the Independence of the United States ofAmerica the Two Hundred and Forty-Second. ATTEST:

Michele Reagan


Join the CRAAZ Board! (We Want You)



We’ve all got experience and knowledge to share, and the best way to get your voice heard is to run for office. While the CTR is required to run for president, there are plenty of positions that don’t require certifications. Whatever your background, we can work with you to find a position that you can make a valuable contribution to.


Do you have concerns about the pricing for membership or for our annual conference? Do you have ideas for educational offerings? Do you have suggestions for how CRAAZ can help the registry community? Join us!


If  you’ve served on the board before, each year is different and I can tell you I already have exciting plans for 2018.


What is the commitment, you ask? 


Not much, actually. We hold our meetings via once-a-month phone calls, so you can contribute from the comfort of your own home. Oh, and you will need to make sure you’re a member of CRAAZ next year.


What are the open positions?


President Elect

Vice President



President Elect requires a CTR (or someone CTR eligible) and is a 3 year commitment (you’ll serve one year as President Elect to learn the ropes, then have your chance to hear “Hail to the Chief” sung in your honor as President your second year (2019), and then you’ll get to enjoy being Immediate Past President and chair of the Nominating Committee. Perks include getting to represent CRAAZ at NCRA when you’re President and getting to plan the conference (you know you want to!).


Vice President means you will be able to vote and attend teleconferences, and you’ll step in when the President can’t. It’s a great learning experience. You’ll need your CTR in case you have to serve as President.


Secretary would give you the opportunity to get to know the Board and become more involved in CRAAZ as well by helping with meeting minutes (no big deal…we even have a template) and maintaining the membership list. You’ll laugh lots and you’ll learn lots, sometimes at the same time.




We’d love to hear your suggestions, and we will gently remind them how amazing they are and see if they’re interested in participating on the CRAAZ Board.




Have we got positions for you! We’re always looking for general membership representatives who can give us feedback from our members on how we can improve CRAAZ. You could help out with the Education conference. Maybe you’re the sort who just love coming up with rules and regulations. There’s the Bylaws Committee to consider. Oh…or you could be great with websites and e-mails (I see that phone out right now). We’d love to have you share your time and your talents, whatever they are.


Let us know what you’re interested in doing and what you’re available for and we’ll find a spot for you. There are fresh baked cookies and balloon animals!



If you’re interested in running for the CRAAZ Board, if you have suggestions for who we should approach, or if you’re interested in serving in a non-elected (appointed) position, please fill out the information form I’ve attached. You can return it to me at or contact past CRAAZ president Iris Castro at


We’ll be voting on Friday, so send us your nominations ASAP.


All my best,



Juliet R. Wilkins, CTR

Immediate Past President/President Elect/Nominating Committee Chair
Cancer Registry Association of Arizona

2017-2018 CRAAZ Nominating Form