Code for the county of the patient’s residence at the time the tumor was diagnosed is a derived (geocoded) variable based on Census Boundary files from 2020 Decennial Census.
This code should be used for county and county-based (such as CHSDA) rates and analysis for all cases diagnosed in 2020-2029.
Census tracts are areas geographically nested within counties and designated with a 6-digit number code. This 6-digit code is commonly repeated within a state in different counties. Census tract numbers are only unique when paired with the state and the county. Therefore, a tract cannot be accurately identified without knowing the county. Example from Massachusetts: Rural Franklin County contains a tract 040600 with 2010 population 4,612 people. Urban Suffolk County contains a tract 040600 with 2,444 people. The county must be known in order to distinguish between the two tract codes. Because we historically used a single variable for County at DX [90], correct tract codes were frequently paired with the wrong county due to incorrect county assignment during abstracting or a change of county over time. Also, some variables, such as the Census Tract Poverty Indicator [145] require the use of the decennial Census County codes closest to year of diagnosis and not the decade of year of diagnosis. Using a single county at diagnosis, and using the reported versus geocoded data, may result in erroneous assignment of geographic location as well as invalid links with census data (i.e. population, poverty category, urban/rural designation).
Instructions for Coding
- This variable is generated through the process of geocoding either during abstracting or at the central registry level. For U.S. residents, this data item stores the county codes issued by the Federal Information Processing Standards (FIPS) publication Counties and Equivalent Entities of the United States, Its Possessions, and Associated Areas. The information in this publication is available in Appendix A.
- It is recommended that geocoding be performed using the NAACCR geocoder.
- It is recommended that all cases diagnosed through 2029 should have a geocoded County at DX Geocode2020.
- At a minimum, all cases diagnosed through 2016-2029 should have a geocoded County at DX Geocode2020. Some cases, such as those diagnosed in 2019, must have both County at DX Geocode2010 and County at DX Geocode2020 codes for proper assignment of the Census Tract Poverty Indicator [145].
- Do not update this item if the patient’s county of residence changes. Store address update information in the affiliated current address data items. Only update based on improved information on the residential address at time of diagnosis.
- PO Box address information should not be used to geocode this data item except in the infrequent case when no other address information is available.
- For cases with a 9 or blank in Census Tr Certainty 2020 AND a valid FIPS code in County at DX [90], the valid FIPS code from Item [90] should be used.
- If the patient has multiple tumors, the county codes may be different for each tumor.
- Detailed standards have not been set for Canadian provinces/territories. Use code 998 for Canadian residents.
- Blank “Not geocoded” is allowable for cases diagnosed before 2015 and after 2029. However, it is preferred to have all cases diagnosed through 2029 geocoded to a County at DX Geocode2020 to allow for both retrospective and cross-sectional analyses.