Free Practice Questions for ODS-C

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Exam pass rate: 51.4% (2025)

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Key Facts: ODS-C Exam

180

Total Questions

120 closed + 60 open-book

2 + 2 hrs

Exam Time

Plus a 15-minute break

51.4%

2025 Pass Rate

NCRA 2025 exam summary

33%

Coding & Abstraction

Largest domain (60 items)

$335–$435

Exam Fee

Member/non-member

20 CE

Per 2-Year Cycle

Plus annual fee

The ODS-C exam has 180 questions: 120 closed-book (Legal/Ethical 30, Registry Operations 45, Data Identification 45) in 2 hours, a 15-minute break, and 60 open-book Coding and Abstraction items in 2 hours. Pass/fail uses the total score against a Modified-Angoff cut; the 2025 pass rate was 51.4%. Eligibility has three routes. The CTR credential was renamed ODS effective January 1, 2024, and is maintained with 20 CE credits every 2 years plus an annual fee.

Sample ODS-C Practice Questions

Try these sample questions to review concepts for the ODS-C exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which ICD-O-3.2 behavior code indicates an in situ neoplasm?

A./0

B./1

C./2

D./3

Explanation: ICD-O-3.2 behavior code /2 denotes carcinoma in situ or intraepithelial neoplasia — the neoplasm has not invaded the basement membrane.

2A patient is diagnosed with infiltrating ductal carcinoma of the upper-outer quadrant of the right breast. Which ICD-O-3.2 topography code is correct?

A.C50.2

B.C50.4

C.C50.8

D.C50.9

Explanation: C50.4 is the ICD-O-3.2 topography code for the upper-outer quadrant of the breast.

3Under AJCC 8th Edition staging, a breast cancer with a 2.5 cm primary tumor, no regional lymph node involvement, and no distant metastasis is classified as which pathologic stage?

A.Stage IA

B.Stage IIA

C.Stage IIB

D.Stage IIIA

Explanation: pT2 (tumor >2 cm but ≤5 cm), pN0, M0 corresponds to AJCC 8th Edition Stage IIA for breast cancer.

4Which SEER Summary Stage category is used when a tumor has spread to regional lymph nodes only with no distant metastasis?

A.In situ

B.Localized

C.Regional

D.Distant

Explanation: SEER Summary Stage 'Regional' includes spread to regional lymph nodes, direct extension to adjacent tissue, or both, without distant metastasis.

5According to STORE (Standards for Oncology Registry Entry), which Class of Case code is assigned to a patient first diagnosed at your facility who also received all treatment at your facility?

A.00

B.10

C.20

D.21

Explanation: Class of Case 10 is assigned when the patient was diagnosed and received all or part of their first-course treatment at the reporting facility.

6The 2007 SEER Multiple Primary and Histology (MP/H) rules state that two tumors in the same site are counted as separate primaries if they have different histologies at what level of the histology table?

A.Same 4-digit ICD-O histology code

B.Different 3-digit histology families

C.Different 4-digit histology codes regardless of behavior

D.Same 2-digit histology group

Explanation: Under SEER MP/H rules, two tumors with different 3-digit histology groups (family-level) are counted as separate primaries, even in the same organ.

7Which data item in the STORE manual captures the date the physician first discussed a cancer diagnosis with the patient?

A.Date of Diagnosis

B.Date of First Contact

C.Date of Inpatient Admission

D.Date of Initial RX/SEER

Explanation: Date of Diagnosis in STORE is defined as the date the diagnosis of cancer was established, which may be the date the physician discussed the findings with the patient.

8Under FORDS coding rules, which surgery code is assigned when a patient with localized prostate cancer undergoes radical prostatectomy?

A.00 — No surgery

B.30 — Local tumor destruction

C.55 — Radical prostatectomy

D.99 — Unknown if surgery performed

Explanation: FORDS Surgery of Primary Site code 55 is assigned for radical prostatectomy (removal of the entire prostate with or without seminal vesicles).

9EDITS software is primarily used in cancer registries to:

A.Generate follow-up letters to patients

B.Validate data quality and identify coding errors

C.Produce Kaplan-Meier survival curves

D.Submit cancer data to insurance payers

Explanation: EDITS (Edit Disclosure Tracking System) software validates cancer registry records by running standardized edit checks that identify coding errors, inconsistencies, and missing required data items.

10A cancer registry abstract includes an ICD-O-3.2 morphology code of 8140/3. What does this represent?

A.Squamous cell carcinoma, NOS

B.Adenocarcinoma, NOS — malignant

C.Adenocarcinoma in situ

D.Transitional cell carcinoma

Explanation: ICD-O-3.2 morphology code 8140 is Adenocarcinoma, NOS; the /3 behavior suffix denotes a malignant primary neoplasm.

About the ODS-C Exam

The ODS-C credential (Oncology Data Specialist, formerly CTR, Certified Tumor Registrar) is NCRA's certification for cancer registry professionals. The exam has 180 four-option items: 120 closed-book items covering Legal and Ethical Aspects, Registry Operations and Data Identification in 2 hours, a mandatory 15-minute break, then 60 open-book items on Coding and Abstraction in 2 hours using searchable PDF references. Pass or fail is based on the total score compared with a Modified-Angoff cut score. Content covers HIPAA and release of information, NCRA ethics, CoC standards, NAACCR, SEER and NPCR, reportability, casefinding, Class of Case, follow-up, ICD-O-3.2, grade, the Solid Tumor and Hematopoietic rules, AJCC and Summary Stage 2018 staging, and STORE 2025 treatment coding.

Exam sponsor: National Cancer Registrars Association (NCRA) / Meazure Learning. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

180 questions

Time Limit

4 hours + 15-minute break

Passing Score

Total score vs. Modified-Angoff cut score

Exam / Certification Fees

$335–$435

Exam sponsor website

Reported exam pass rate: 51.4% (2025). about 59% for first-time candidates in 2025; domain scores are not pass/fail This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

17% (30 items)

Legal and Ethical Aspects

Release-of-information and research laws, subpoenas and court orders, HIPAA privacy and security safeguards for PHI, the NCRA Code of Ethics, state and federal cancer reporting requirements

25% (45 items)

Cancer Registry Operations

Standard setters (CAP, CoC, NAACCR, NCCN, NPCR, SEER), hospital and central registry types, central registry edits, quality improvement, CoC quality control plans, casefinding and QA audits, frequency distributions, measures of central tendency, relative risk and odds ratios

25% (45 items)

Cancer Registry Data Identification

Medical terminology and anatomy, reportability, types of cancer, primary site and histology, casefinding methods, hematopoietic rules, pathology reporting, data items required by standard setters, source documents, diagnostic and staging procedures, prognostic indicators, lab methods such as FISH and RT-PCR, treatment types, follow-up

33% (60 items, open book)

Cancer Registry Coding and Abstraction

Solid Tumor Rules, staging (AJCC 8th edition breast, male genital and urinary tract chapters, AJCC Version 9 lung, Summary Stage 2018, Grade Manual) and STORE 2025 treatment coding, using the references on NCRA's 2026 open-book list

Preparing for the ODS-C Exam

What You Need to Know

Passing score: Total score vs. Modified-Angoff cut score
Exam length: 180 questions
Time limit: 4 hours + 15-minute break
Exam / certification fees: $335–$435 Official sources

Using Our Practice Resources

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

ODS-C: Suggested Study Strategy

1Get NCRA's 2026 open-book reference PDFs early and practice searching them under time pressure; the open-book part allows 2 minutes per item

2Learn STORE Class of Case definitions exactly, including refusal (14) and unknown treatment location (10)

3Work through the Solid Tumor Rules in order: use the first rule that applies and stop, and know each module's timing rule

4Practice the Grade Manual's four grade items, especially Grade Pathological 9 after neoadjuvant therapy

5Stage breast, prostate, testis, kidney, bladder and Version 9 lung cases with the AJCC chapters on the reference list

6Know CoC standards used in registry work: 4.3 staff credentials, 5.1 CAP synoptic audit, 6.1 quality control (10% up to 200 cases), 6.4 RCRS, and 6.5 follow-up (80% and 90%)

7Memorize the HIPAA public health disclosure rule and how to handle subpoenas and court orders

8Review the reportability exceptions (skin 8000–8110, cervical CIS/CIN III, PIN III) and the ambiguous terms lists

9Practice STORE treatment coding: surgery B-codes, scope of lymph node surgery, radiation phases, and reason-for-no-treatment codes

10Use timed full-length practice to build pacing for the 2-hour closed-book part

Frequently Asked Questions

What is the ODS-C exam?

The ODS-C (Oncology Data Specialist, Certified) is NCRA's credential for cancer registry professionals. It was called the CTR (Certified Tumor Registrar) until the name changed to ODS effective January 1, 2024, and holders may use ODS, ODS-C or ODS-Certified. The exam covers legal and ethical aspects, registry operations, data identification, and coding and abstraction.

How many questions are on the ODS-C exam and how long is it?

There are 180 four-option questions. The closed-book part has 120 questions (Domains 1–3) with 2 hours; after a mandatory 15-minute break, the open-book part has 60 questions (Domain 4) with 2 hours. Unused time does not carry over, and you cannot return to the closed-book part.

What is the ODS-C passing score?

NCRA compares your total score across all 180 items with a passing score set by the Modified-Angoff method and adjusted by statistical equating between forms. It does not publish a fixed percentage, and the domain percentages on your score report are not pass/fail.

What is the ODS-C pass rate?

NCRA's summary of the 2025 exam reports a 51.4% overall pass rate (410 passed of nearly 800 candidates) and about 59% for first-time candidates.

What are the ODS-C eligibility requirements?

Route 1 is an NCRA-accredited associate degree program with practicum. Route 2 is 60 college credits plus an NCRA-accredited certificate program with practicum. Route 3 is 60 college credits, including two semesters of anatomy and physiology with a grade of C or better, plus 1,950 hours of cancer registry experience.

How much does the ODS-C exam cost?

The fee is $335 for NCRA members and $435 for non-members. Testing at an international center adds $150. Transferring to another window costs $125, and a withdrawal is refunded less a $125 fee. A retake requires a new application and the full fee.

When are the 2026 ODS-C testing windows?

March 20–April 11 (application deadline March 6), July 3–25 (deadline June 19), and October 23–November 14 (deadline October 7). You can test by live remote proctoring or at a Meazure Learning test center.

What references can I use in the open-book section?

Only the searchable PDFs on NCRA's 2026 list: selected AJCC 8th edition chapters (Breast, Male Genital Organs, Urinary Tract) plus the AJCC Version 9 lung protocol, STORE 2025 Appendix A and the Radiation chapter, the Grade Manual v3.2, the 2025 Solid Tumor Rules and Summary Stage 2018 v3.3. The first 120 items are closed book.

How is the ODS credential maintained?

Earn at least 20 CE credits in each 2-year cycle ending December 31, including at least 4 Category A credits, plus 8 NCRA-approved in-person (CEIP) credits per 4-year cycle counted within the 20, and pay the annual maintenance fee.