One of the first and most important steps in the treatment of cancer is staging. Staging is a process of classifying the extent of cancer and how far it has spread. The TNM system was developed by the American Joint Committee on Cancer (AJCC) to standardize classification of cancer extent. The system uses a "T" for tumor size, "N" for lymph node, and "M" for metastasis. After the physician has determined the TNM groups, a stage grouping is assigned for the patient. This is usually indicated by 0, I, II, III, and IV. A higher stage group number usually indicates more advanced cancer. Some cancers or tumors are not staged using this system.
Once a diagnosis of cancer is made the attending physician at the time of discharge is required to complete an AJCC staging form. (UMMC requires the staging form be used to document the stage of disease.) The medical record will remain incomplete until the attending physician at the time of discharge completes the form.
The UMMC Clinical Cancer Activities Committee and the UMHC Executive Committee have defined responsibility for completing AJCC staging forms. The attending physician at discharge is required to complete the form for hospitalized patients. Patients seen or diagnosed in the outpatient setting will be staged by the attending physician who diagnosed the patient or to whom the patient was referred in the outpatient setting.
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