Form:Canary: PASS Biopsy v3.0


CDE IDCDE Description
* 421EDRN Participant ID (Go To: 973)
* 973Date of prostate biopsy (MM/DD/YYYY): (Go To: 423)
* 423EDRN Protocol ID (Go To: 422)
* 422EDRN Site ID (Go To: 929)
* 929EDRN Staff ID of the person who collected the data: (Go To: 578)
* 578Age at specimen collection (Go To: 839)
   839ID number of local pathology report: (Go To: 2714)
* 2714Procedure performed at the study site? (Go To: 2174)
 
Permissible Values (value):No (0)
 
 Yes (1)
 
 Unknown (99)
   2174Indication for current prostate biopsy (Check all that apply.) (Go To: 1692)
 
Permissible Values (value):Rising PSA (1)
 
 Elevated PSA (2)
 
 Abnormal DRE (3)
 
 Abnormal biopsy (4)
 
 Atypical small acinar proliferation (ASAP) (6)
 
 Family history (7)
 
 High grade PIN (8)
 
 Surveillance biopsy (9)
 
 Suspicious MRI (27)
 
 Other, specify: (97) (Go To: 1578)
   1578Indication for prostate biopsy, other specify: (Go To: 1692)
   1692Prostate size (by TRUS): (Go To: 980)
* 980Total number of cores taken: (Go To: 2872)
* 2872Total number of cores with cancer: (Go To: 4538)
 
Permissible Values (value):0 (0)
 
 1 (1)
 
 2 (2)
 
 3 (3)
 
 4 (4)
 
 5 (5)
 
 6 (6)
 
 7 (7)
 
 8 (8)
 
 9 (9)
 
 10 (10)
 
 11 (11)
 
 12 (12)
 
 13 (13)
 
 14 (14)
 
 15 (15)
 
 16 (16)
 
 17 (17)
 
 18 (18)
 
 19 (19)
 
 20 (20)
 
 >20 (40)
 
 Unknown (99)
   4538Number of systematic cores: (Go To: 4540)
   4540Number of targeted cores: (Go To: 4541)
* 4541Was a MRI/US Fusion Biopsy performed? (Go To: 2158)
 
Permissible Values (value):No (0)
 
 Yes (1) (Go To: 955)
 
 No, in-gantry (2)
 
 Unknown (99)
   955Date of imaging test (MM/DD/YYYY): (Go To: 2158)
* 2158Number of specimens: (Go To: 2159)
* 2159Specimen line number or identifier (system-generated): (Go To: 2709)
* 2709Specimen identifier: (Go To: 2160)
* 2160Tissue position (laterality): (Go To: 2211)
 
Permissible Values (value):Right (1)
 
 Left (2)
 
 Unknown/refused (99)
   2211Tissue position (zone): (Go To: 2213)
 
Permissible Values (value):Transition Zone (TZ) (1)
 
 Seminal vesicle (2)
 
 Anterior zone (3)
 
 Posterior zone (5)
   2213Tissue position (regionality): (Go To: 2212)
 
Permissible Values (value):Apex (A) (1)
 
 Middle (M) (2)
 
 Base (B) (3)
   2212Tissue position (position within region): (Go To: 4539)
 
Permissible Values (value):Lateral (lat) (1)
 
 Medial (med) (2)
   4539Type of tissue targeting (Go To: 2712)
 
Permissible Values (value):No (0)
 
 Yes (1)
 
 Unknown (99)
* 2712Specimen status (normal or abnormal): (Go To: 1097)
 
Permissible Values (value):Normal (1)
 
 Positive for malignancy (3) (Go To: 2210)
 
 Abnormal but negative for malignancy (4)
 
 Unknown (99)
   2210Percent of cancer in tissue: (Go To: 2209)
   2209Length of tissue specimen (mm): (Go To: 2208)
   2208Length of cancer in tissue specimen (mm): (Go To: 4596)
   4596ISUP prostate histopathologic grade: (Go To: 1589)
 
Permissible Values (value):Grade Group 1 (1)
 
 Grade Group 2 (2)
 
 Grade Group 3 (3)
 
 Grade Group 4 (4)
 
 Grade Group 5 (5)
 
 Not applicable (98)
* 1589Primary Gleason grade: (Go To: 1590)
* 1590Secondary Gleason grade: (Go To: 1697)
* 1697Overall Gleason Score: (Go To: 1097)
   1097Comments (do not include any participant identifiers) (Go To: End of Form)