Form 4 Initial Biospecimen and Cancer Count Information Form

	Biospecimen and Cancer Count Information Spreadsheet
	Biospecimen and Cancer Count Information Spreadsheet
1	Cohort Name:
2	Specify if the cancers are Incident Cancers or Prevalent Cancers:
3	Notes:
	ICD-9	ICD-10/O	Cancer Type	Males	Females	Blood	Buccal	Feces	Lymphocytes	Tumor Tissue	Sputum	Urine	Other Specify:	Other Specify:
4			No Cancer
5	141-149	C00-C14	Oropharyngeal
6	150	C15	Esophagus
7	151	C16	Stomach
8	152	C17	Small intestine
9	153	C18	Colon
10	154	C19-C21	Rectum and anus
11	155	C22	Liver and intrahepatic bile ducts
12	156	C23, C24	Gall bladder and extrahepatic bile duct
13	157	C25	Pancreas
14	162	C33, C34	Trachea, bronchus, and lung
15	170	C40	Bone
16	172	C43	Melanoma (excluding genital organs)
17	174-175	C50	Breast
18	180	C53	Cervix
19	182	C54	Corpus, body of uterus
20	183	C56	Ovary, fallopian tube, broad ligament
21	185	C61	Prostate
22	188	C67	Bladder
23	189	C64-C66, C68	Kidney and other unspecified urinary organs including renal pelvis, ureter, urethra
24	191	C71	Brain
25	193	C73	Thyroid
26	200-202	C81-C85	Lymphoma (HL and NHL)
27	203	C90	Myeloma
28	204-208	C91-C95	Leukemia