100+ Free ODS-C Practice Questions

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Question 1

Score: 0/0

A 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?

C50.9

C50.2

C50.8

C50.4

to track

2026 Statistics

Key Facts: ODS-C Exam

180

Total Questions

120 closed + 60 open-book

4 hrs

Exam Time

NCRA 2026

70%

Passing Score

Per domain

33%

Coding & Abstraction

Largest domain (60 items)

$335–$435

Exam Fee

Member/non-member

2 years

Recert Cycle

20 CE hours required

The ODS-C exam contains 180 questions (120 closed-book + 60 open-book) over 4 hours. Passing requires 70% in each of the four domains: Legal/Ethical (30 items), Registry Operations (45 items), Data Identification (45 items), and Coding/Abstraction (60 items). Eligibility has three routes based on education plus registry experience or accredited program completion. The credential was renamed from CTR to ODS-C in 2023 and is maintained with 20 CE hours every 2 years.

Sample ODS-C Practice Questions

Try these sample questions to test your ODS-C exam readiness. 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 (formerly CTR — Certified Tumor Registrar) is NCRA's flagship credential for cancer registry professionals. The exam contains 180 multiple-choice items in two sections: a closed-book section (120 items across Legal/Ethical, Operations, and Data Identification domains) and an open-book section (60 items in Coding and Abstraction). Candidates have 4 hours total and must achieve 70% in each domain. Content covers ICD-O-3.2 coding, AJCC 8th Edition TNM staging, SEER Summary Stage, SEER MP/H multiple primary rules, STORE and FORDS abstracting, HIPAA, NAACCR data standards, SEER/NPCR surveillance programs, and CoC accreditation requirements.

Questions

180 scored questions

Time Limit

4 hours

Passing Score

70% within each of the four content domains

Exam Fee

$335–$435 (National Cancer Registrars Association (NCRA) / Meazure Learning)

ODS-C Exam Content Outline

17% (30 items)

Legal and Ethical Aspects

HIPAA Privacy and Security Rules, state mandatory cancer reporting laws, data use agreements, patient rights, confidentiality obligations, breach assessment, subpoena response, professional ethics, ODS-C credential and recertification requirements

25% (45 items)

Cancer Registry Operations

Registry management, staffing, casefinding completeness, CoC accreditation standards, data quality audits (reabstraction, timeliness, completeness), NAACCR data standards and file formats, SEER and NPCR surveillance programs, cancer statistics (incidence, prevalence, survival, mortality, age-standardization)

25% (45 items)

Cancer Registry Data Identification

Reportability rules, ambiguous terminology list, analytic vs. non-analytic cases, Class of Case, casefinding sources (pathology, lab, ICD codes), follow-up methods, vital status ascertainment (NDI, DMF, physician contact), lost-to-follow-up management

33% (60 items — open book)

Cancer Registry Coding and Abstraction

ICD-O-3.2 topography and morphology codes, behavior and grade codes, AJCC 8th Edition TNM pT/N/M categories and stage grouping (all sites), SEER Summary Stage 2018, SEER MP/H multiple primary and histology rules, STORE data items (date fields, treatment codes, sequence numbers, no-treatment reason codes), FORDS surgery codes, site-specific data items (SSDIs), EDITS validation, Collaborative Stage history

How to Pass the ODS-C Exam

What You Need to Know

Passing score: 70% within each of the four content domains
Exam length: 180 questions
Time limit: 4 hours
Exam fee: $335–$435

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ODS-C Study Tips from Top Performers

1Master ICD-O-3.2 topography and morphology codes for the most common cancer sites (breast, colon, lung, prostate, lymphoma, leukemia)

2Study AJCC 8th Edition TNM staging for top-volume sites: breast, colon, prostate, lung, and melanoma

3Know SEER MP/H rules for paired organs (breast) and same-site tumors (colon subsites, lung lobes)

4Understand STORE data items thoroughly: date fields, Class of Case, Sequence Number, treatment reason codes

5Memorize the HIPAA public health activities exception and the minimum necessary standard

6Know CoC accreditation standards: 95% casefinding completeness, 90% staging completeness, 4+ cancer committee meetings/year

7Learn the differences between SEER, NPCR, and CoC/NCDB — what each program collects and from whom

8Practice EDITS logic: understand why over-ride flags exist and when they are appropriate

9Review the multiple primary rules hierarchy: organ-specific rules override general histology rules

10For the open-book section, organize your reference tabs in advance — time management is critical

Frequently Asked Questions

What is the ODS-C exam?

The ODS-C (Oncology Data Specialist — Certified) is NCRA's professional credential for cancer registry specialists. Formerly called the CTR (Certified Tumor Registrar), it was renamed in 2023. The exam validates expertise in cancer data collection, ICD-O-3.2 coding, AJCC TNM staging, STORE abstracting, HIPAA compliance, and cancer surveillance.

How many questions are on the ODS-C exam?

The ODS-C exam contains 180 multiple-choice questions in two sections: a closed-book section (120 items covering Legal/Ethical, Registry Operations, and Data Identification) and an open-book section (60 items covering Coding and Abstraction). Candidates have 4 hours total.

What is the ODS-C passing score?

Candidates must achieve a score of at least 70% within each of the four content domains. All four domains must be passed independently; a high score in one domain does not compensate for failing another.

What are the ODS-C eligibility requirements?

There are three routes: Route 1 requires completing an NCRA-accredited Associate Degree in Cancer Registry Management; Route 2 requires an Associate degree (or 60 college credits) plus an NCRA-accredited Certificate program; Route 3 requires any Associate degree (or 60 credits) including two semesters of Anatomy/Physiology (grade C+) plus 1,950 hours of cancer registry work experience.

How much does the ODS-C exam cost?

The exam fee is $335 for NCRA members and $435 for non-members. A $125 transfer fee applies for changing to a different testing window within the same cycle.

When are the 2026 ODS-C testing windows?

Three windows are available in 2026: March 20–April 11 (application deadline March 6), July 3–25 (deadline June 19), and October 23–November 14 (deadline October 7). The exam is offered via Meazure Learning in-person or remote proctored.

How is ODS-C certification maintained?

ODS-C holders must complete 20 continuing education hours every 2 years and pay an annual maintenance fee. CE credits must be relevant to cancer registry practice. NCRA also offers a CEIP (Continuing Education Intensive Program) pathway.

What reference materials are allowed on the ODS-C exam?

The Coding and Abstraction section (60 items) is open-book — approved references such as ICD-O-3 coding manuals and STORE may be used. The remaining three domains (120 items) are closed-book.