16.4 NAACCR EDITS, Over-ride Flags & Data Validation

What EDITS are

EDITS are computerized logic checks, maintained through NAACCR, that registry software runs on each abstract and on data files. Their parts:

Types of edits:

1. Single-item (field) edits: the value is valid for the item. For example, Laterality must be 0–5 or 9, and dates must be valid.
2. Inter-field edits: combinations within one tumor record. Examples: primary site with histology, site with laterality, diagnostic confirmation with histology, surgery with diagnostic confirmation, age with site and histology, and AJCC or Summary Stage with schema.
3. Inter-record edits: consistency across all records for one patient. Examples: the same date of birth and vital status on every tumor, and a coherent set of sequence numbers.

How CoC programs use edits

• Date Case Completed–CoC [2092] is set by the software when the items required for the case's Class of Case are abstracted and the case passes the "Hosp: CoC Required - All" edit set (Section 13.1).
• The NCDB runs edits on RCRS submissions and rejects or flags records that fail. Programs correct them and resubmit.
• Standard 6.1 quality control covers casefinding, abstracting timeliness, unknown values and accuracy reviews. Edits help, but they do not replace the 10% accuracy review.

Resolving an edit error

1. Read the message. Note which items the edit compares.
2. Look up the edit's logic. The edit description explains what combination is flagged and why.
3. Check the source documents (pathology, operative report, imaging, physician notes) and the coding manuals.
4. If the abstract is wrong, correct it. This is the usual outcome. Typical causes are a transposed code, a laterality entered for an unpaired site, or a sequence number not updated after a new primary.
5. If the combination is rare but correct, document the evidence in text and set the matching over-ride flag to 1. The flag tells the edit that the combination was reviewed. It is not a way to clear an error queue.
6. Re-run edits.

Over-ride flags and review items (NAACCR item numbers)

Examples:

• For the CoC version of the site/type edit, skin C44 with histologies 8000–8110 (keratinocyte carcinomas) needs no override.
• Male breast cancer is a valid combination and does not fail a site/sex edit. Sex-impossible combinations, such as a male patient with a primary site of cervix, point to a coding error.

Sex Assigned at Birth (2026)

The SEER 2026 manual introduces Sex Assigned at Birth [225], effective for 2026 diagnoses and replacing the old Sex item, with codes 1 male, 2 female, 9 not stated or unknown. If sex is unknown, assign 1 for male genital sites (C600–C639) and 2 for female genital sites (C510–C589). Code 9 is used for DSD with sex not clearly defined, or when only a non-binary or transgender identity is documented without sex at birth. Edits compare this item with sex-specific primary sites.

Dates in edits

Dates are transmitted as CCYYMMDD, with blanks for unknown trailing parts and date flag items explaining why a date is blank. The old "99" unknown convention belonged to the pre-2010 format. Edits check that dates are valid and in logical order. For example, the date of diagnosis cannot follow the date of last contact, and the date of first course of treatment is not usually before the date of diagnosis.

What edits cannot do

Edits cannot tell whether a valid code is the right code. For example, C504 versus C502 with the same histology passes every edit, even if the tumor was in the upper-inner quadrant. Accuracy needs:

• visual editing (a second person reviewing text against codes);
• the Standard 6.1 accuracy review (10% of analytic cases, up to 200);
• central registry re-abstracting and casefinding audits;
• NAACCR certification criteria, including 100% passing EDITS for Gold (Section 6.3).

Worked examples

1. Edit: "Laterality, Primary Site" fails for C18.7 coded laterality 1. The sigmoid colon is not a paired site, so correct laterality to 0. No override.
2. Edit: Site/Type fails for primary melanoma of the esophagus, confirmed by IHC (S100, SOX10) and a physician statement with no skin primary. Document the evidence in text and set Site/Type Interfield Review [2030] = 1.
3. Edit: inter-record, Vital Status 0 on one record and 1 on another for the same patient. Vital status is patient-level, so correct both records to 0 and use the same date of last contact.