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Enter the month, day, and year of the initial diagnosis (YYYYMMDD format)

• Code the date using a zero to precede single digit days, or months, i.e., June is entered as 06

This field refers to the date of first diagnosis of this cancer by a recognized medical practitioner. This is the date of the first clinical diagnosis, and in some cases, the diagnosis may never be histologically confirmed. Do not change the date of diagnosis when a later biopsy or cytology provides confirmation of a clinical diagnosis.  From 2009 forward, for cases which are diagnosed in utero, record the actual date of diagnosis.  For pre-2009 cases, the date of diagnosis for in utero cases should be the date of birth.  

1.Code the month, day and year the tumor was first diagnosed, clinically or microscopically, by a
recognized medical practitioner

a.When the first diagnosis includes reportable ambiguous terminology, record the date of
that diagnosis

Note: The date of the

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If the exact date is not known, record the best approximation on the basis of available information. As possible guidelines, consider the following:

a.        For patients diagnosed without positive tissue while in a hospital, the date of admission may be used as the best estimate of the date of diagnosis.

b.        For patients diagnosed before entering the hospital (i.e., clinic or physician's office), the date of first admission may be used if it seems that the patient was hospitalized within three months or less from the true date of diagnosis by the referring physician.

c.        If the only information is "Spring of", "Middle of the year", or "Fall", "Beginning of", "First of" approximate these as April 1st, July 1st, or October 1st, and the corresponding month to the "beginning of" or "first of" respectively.

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suspicious cytology may be used as the date of diagnosis when a definitive diagnosis follows the suspicious cytology for cases beginning 01/01/2022 forward. Do not use ambiguous cytology alone for case ascertainment.

2.When theonlyinformation available is a positive pathology or cytology report, code the date
the biopsy wasdone, not the date the report was dictated or transcribed

3.Code the date the procedure was done, not the date the specimen was received or read as
positive by the pathologist when the date of diagnosis is coded from a pathology report

4.The first diagnosis of cancer may beclinical(i.e., based on clinical findings or physician’s
documentation)

Note:Donotchange the date of diagnosis when a clinical diagnosis is subsequently confirmed
by positive histology or cytology.

Note:Appendix E in the 2023 SEER Program Manual lists which PI-RADS, BI-RADS,
and LI-RADS are reportable versus non-reportable. If reportable, use the date of the
imaging procedure as the date of diagnosis when this is the earliest date and there is no
information to dispute the imaging findings.

5.Positivetumor markersalone arenotdiagnostic of cancer. Use the date of clinical, histologic,
or positive cytologic confirmation as the date of diagnosis.

Note:Positive tumor markers alone are never used for case ascertainment.

6.Use the date of suspicious cytology when the diagnosis is proven by subsequent biopsy,
excision, or other means

Note 1:“Suspicious” cytology means that the diagnosis is preceded by anambiguous termsuch
as apparently, appears, compatible with, etc.

Note 2:Donotuse ambiguous cytologyalonefor case ascertainment.

7.Code theearlier dateas the date of diagnosis when

a.A recognized medical practitioner says that, inretrospect, the patient had cancer at an
earlier date or

b.The original slides arereviewed and the pathologist documents that cancer was present.
Code the date of the original procedure as the diagnosis date.

Note:Donotback-date the diagnosis when
•The information on the previous tumor is unclearAND/OR
•There isno reviewof previous slidesAND/OR
•There isno physician’s statementthat, in retrospect, the previous tumor was malignant

8.Code thedate of deathas the date of diagnosis for autopsy only cases

9.Death certificate only (DCO) Cases

a.Use information on the death certificate to estimate the date of diagnosis

b.Record the date of death as the date of diagnosis when there is not enough information
available to estimate the date of diagnosis; for example, the time from onset to the date of
death is described as ‘years’

c.If no information is available, record the date of death as the date of diagnosis

10.Estimate the date of diagnosisif an exact date is not available. Use all information available to
calculate the month and year of diagnosis.

a.Estimating themonth

i.Code “spring” to April

ii.Code “summer” or “middle of the year” to July

iii.Code “fall” or “autumn” as October

iv.For “winter” try to determine whether the physician means the first of the year or
the end of the year and code January or December as appropriate. If no
determination can be made, use whatever information is available to calculate the
month of diagnosis.

v.Code “early in year” to January

vi.Code “late in year” to December

vii.Use whatever information is available to calculate the month of diagnosis

viii.Code the month of admission when there is no basis for estimation

ix.Leave month blank (or convert 99 to blank) if there is no basis for approximation

b.Estimating theyear

i.Code “a couple of years” to two years earlier

ii.Code “a few years” to three years earlier

iii.Use whatever information is available to calculate the year of diagnosis

iv.Code the year of admission when there is no basis for estimation

11.Ifno informationabout the date of diagnosis is available

a.Case transmitted to NCI SEER

i.Use the date of admission as the date of diagnosis

ii.In the absence of an admission date, code the date of first treatment as the date of
diagnosis

b.CaseNOTtransmitted to NCI SEER

i.Code month and year as unknown

Nursing Home and Hospice Residents (Not hospitalized for their cancer; no information other
than nursing home or hospice records and/or death certificate)

1.Use thebest approximationfor the date of diagnosis when the only information available is
that the patienthad cancer while in the nursing homeand it is unknown whether the patient
had cancer when admitted

2.Code thedate of admissionto the nursing home as the date of diagnosis when

a.Theonly information availableis that the patient had cancer when admitted to the
nursing home

b.Theonly information availableis that the patient had cancer while in the nursing home,
it is unknown whether the patient had cancer when admitted, and there isno basis for
approximation

Cases Diagnosed Before Birth
Record the actual date of diagnosis for diagnoses made in utero even though this date will precede the date of
birth.

Note: Prenatal diagnoses are reportable when there is a live birth.

The date of death is the date of diagnosis for a class of case 38.

See SEER Manual (pages 83-87) for Examples