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Item # Length Source of Standard Year Implemented Version Implemented Year Retired Version Retired
90 3 FIPS/SEER

NAACCR XML: Tumor.countyAtDx

Alternate Names
   County (pre-96 SEER/CoC)
   County at Diagnosis (CoC)
   County at DX
Description
Code for the county of the patients residence at the time of diagnosis as identified by the Reporting Source. For U.S. residents, standard codes are those of the FIPS publication Counties and Equivalent Entities of the United States, Its Possessions, and Associated Areas or their equivalent INCITS codes.

Calculating county and county-based variable rates using this item is not recommended. The more specific, geocoded county items should be used when available.
 
Rationale
This data item may be used for epidemiological purposes. For example, to measure cancer incidence in a particular geographic area.

Instructions for Coding
  • This field is intended to store address information for the patient's physical, residential address. All efforts should be made to find the patient's true street address and postal code, including reviewing relevant sources outside the medical record if available. The county for a PO Box mailing address should only be recorded when no other address information is available in the medical record and no other information sources are available.
  • If the patient has multiple tumors, county at diagnosis may be different for each tumor.
  • Do not update this item if the patient's county of residence changes. Store updated address information in the affiliated current address data items. Only update based on improved information on the residential address at time of diagnosis. For instance, it is appropriate to correct county during a consolidation process.
  • This variable is coded at time of abstracting and is considered less accurate than the derived, geocoded county at diagnosis variables: County at Diagnosis 1990, 2000, 2010, & 2020.
  • Detailed standards have not been set for Canadian provinces/territories. Use code 998 for Canadian residents.
Note: See Appendix A for standard FIPS county codes. See EDITS Table BPLACE.DBF in Appendix B for geocodes used by CoC.

Note:
SEER does not use code 998. CoC uses country geocodes for nonresidents of the United States (see Appendix B) and 998 for residents of other states.
Codes (in addition to FIPS and Geocodes)
001-997 Valid FIPS code
998 Known town, city, state, or country of residence but county code not known AND a resident outside of the state of reporting institution (must meet all criteria). Use this code for Canadian residents.
999 The county of the patient is unknown, or the patient is not a United States resident. County is not documented in the patient's medical record.
Note: For U.S. residents, historically, standard codes are those of the FIPS publication Counties and Equivalent Entities of the United States, Its Possessions, and Associated Areas. These FIPS codes (FIPS 6-4) have been replaced by INCITS standard codes; however, there is no impact on this variable as the codes align with the system the Census used for each decennial census and changes will automatically be accounted for during geocoding. County codes issued by the Federal Information Processing Standards (FIPS) publication Counties and Equivalent Entities of the United States, Its Possessions, and Associated Areas is available in Appendix A.




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