COC STANDARDS FOR 2026/2027: COMPREHEN
ADVANCED EXAMINATION QUESTION
With BANK
Complete Solutions, Detailed Rationales, and
Evidence
-Based References
EXAMINATION OVERVIEW
Total Questions: 150 Multiple-Choice Questions
Time Allowed: 5 hours 40 minutes
Passing Score: 70% or higher
Target Audience: Oncology Data Specialists, Cancer Registry Professionals, Healthcare
Compliance Officers, and Facility Coding Personnel
Reference Materials: Optimal Resources for Cancer Care (2020 Standards, updated
March 2026), STORE Manual, NCDB Reporting Requirements
PART I: COMMISSION ON CANCER (CoC) STANDARDS
– 2026 UPDATES AND IMPLEMENTATION
Section 1: Standard 7.1 – Quality Measures Reinstatement
Question 1
Starting with CoC Site Visits in 2026, which standard has been reinstated as an
accreditation requirement after a period of suspension?
A) Standard 5.3 – Operative Standards for Breast Cancer
B) Standard 7.1 – Quality Measures
,C) Standard 4.2 – Oncology Nursing Credentials
D) Standard 8.1 – Psychosocial Distress Screening
Correct Answer: B
Rationale: Standard 7.1: Quality Measures will be reinstated as an accreditation
requirement starting with CoC Site Visits in 2026. During 2025, programs must review
their performance on selected quality metrics, identify deficiencies, and document their
review and actions in cancer committee minutes. The standard specifically requires that
for patients undergoing a colon resection for colon cancer, at least 12 regional lymph
nodes are removed and pathologically examined at time of resection.
Question 2
For patients undergoing a colon resection for colon cancer, what is the minimum
number of regional lymph nodes that must be removed and pathologically examined to
meet Standard 7.1 compliance?
A) 10
B) 12
C) 15
D) 20
Correct Answer: B
Rationale: Standard 7.1 specifies that at least 12 regional lymph nodes must be
removed and pathologically examined at the time of resection for colon cancer patients.
This quality measure is part of the reinstated Standard 7.1 requirements effective with
2026 site visits.
Question 3
What action must cancer programs take during 2025 to prepare for the 2026
reinstatement of Standard 7.1?
A) Submit a waiver request to the CoC
B) Review performance on selected quality metrics, identify deficiencies, and document
findings in cancer committee minutes
,C) Conduct a complete overhaul of the cancer registry
D) Submit retrospective data for the previous five years
Correct Answer: B
Rationale: During 2025, programs must review their performance on selected quality
metrics, identify any deficiencies, and document their review and any appropriate
actions in the cancer committee minutes. This preparatory work ensures programs are
ready for compliance evaluation during 2026 site visits.
Section 2: Operative Standards 5.3–5.6 – Internal Audit
Requirements
Question 4
Beginning in 2026, programs must conduct an internal audit each calendar year to
confirm what percentage of compliance with the technical requirements and synoptic
operative reporting requirements of Standards 5.3–5.6?
A) 70%
B) 75%
C) 80%
D) 90%
Correct Answer: C
Rationale: Beginning in 2026, programs must conduct an internal audit each calendar
year to confirm 80% compliance with the technical requirements and synoptic operative
reporting requirements of Standards 5.3–5.6. This represents a significant quality
assurance requirement for accredited cancer programs.
Question 5
By what date are programs expected to develop the protocol and initiate the process for
internal audits of Standards 5.3–5.6?
, A) January 1, 2025
B) January 1, 2026
C) July 1, 2026
D) January 1, 2027
Correct Answer: B
Rationale: Starting January 1, 2026, programs are expected to develop the protocol and
initiate the process for internal audits of Standards 5.3–5.6. This implementation timeline
ensures programs have adequate time to establish compliant audit processes.
Question 6
Which of the following statements accurately describes the compliance pathway for
Standards 5.3–5.6 for 2026 site visits?
A) Programs must achieve 100% compliance with all technical requirements
B) An alternative compliance pathway is available for 2024, 2025, and 2026 site visits
C) Programs are exempt from Standards 5.3–5.6 until 2027
D) Only academic medical centers must comply with Standards 5.3–5.6
Correct Answer: B
Rationale: There is a temporary alternative pathway for compliance with Standards 5.3–
5.6 for 2024, 2025, and 2026 site visits. A site may use this pathway to be fully compliant
with Standards 5.3–5.6 at its next site visit. The alternative pathway provides flexibility
while programs work toward full compliance.
Question 7
Effective January 1, 2026, what change applies to the use of fillable PDF forms for the
synoptic requirements of CoC Standards 5.3–5.6?
A) Fillable PDF forms remain compliant for all cases
B) Fillable PDF forms will no longer be compliant
C) Fillable PDF forms are required for all cases
D) Fillable PDF forms are optional
ADVANCED EXAMINATION QUESTION
With BANK
Complete Solutions, Detailed Rationales, and
Evidence
-Based References
EXAMINATION OVERVIEW
Total Questions: 150 Multiple-Choice Questions
Time Allowed: 5 hours 40 minutes
Passing Score: 70% or higher
Target Audience: Oncology Data Specialists, Cancer Registry Professionals, Healthcare
Compliance Officers, and Facility Coding Personnel
Reference Materials: Optimal Resources for Cancer Care (2020 Standards, updated
March 2026), STORE Manual, NCDB Reporting Requirements
PART I: COMMISSION ON CANCER (CoC) STANDARDS
– 2026 UPDATES AND IMPLEMENTATION
Section 1: Standard 7.1 – Quality Measures Reinstatement
Question 1
Starting with CoC Site Visits in 2026, which standard has been reinstated as an
accreditation requirement after a period of suspension?
A) Standard 5.3 – Operative Standards for Breast Cancer
B) Standard 7.1 – Quality Measures
,C) Standard 4.2 – Oncology Nursing Credentials
D) Standard 8.1 – Psychosocial Distress Screening
Correct Answer: B
Rationale: Standard 7.1: Quality Measures will be reinstated as an accreditation
requirement starting with CoC Site Visits in 2026. During 2025, programs must review
their performance on selected quality metrics, identify deficiencies, and document their
review and actions in cancer committee minutes. The standard specifically requires that
for patients undergoing a colon resection for colon cancer, at least 12 regional lymph
nodes are removed and pathologically examined at time of resection.
Question 2
For patients undergoing a colon resection for colon cancer, what is the minimum
number of regional lymph nodes that must be removed and pathologically examined to
meet Standard 7.1 compliance?
A) 10
B) 12
C) 15
D) 20
Correct Answer: B
Rationale: Standard 7.1 specifies that at least 12 regional lymph nodes must be
removed and pathologically examined at the time of resection for colon cancer patients.
This quality measure is part of the reinstated Standard 7.1 requirements effective with
2026 site visits.
Question 3
What action must cancer programs take during 2025 to prepare for the 2026
reinstatement of Standard 7.1?
A) Submit a waiver request to the CoC
B) Review performance on selected quality metrics, identify deficiencies, and document
findings in cancer committee minutes
,C) Conduct a complete overhaul of the cancer registry
D) Submit retrospective data for the previous five years
Correct Answer: B
Rationale: During 2025, programs must review their performance on selected quality
metrics, identify any deficiencies, and document their review and any appropriate
actions in the cancer committee minutes. This preparatory work ensures programs are
ready for compliance evaluation during 2026 site visits.
Section 2: Operative Standards 5.3–5.6 – Internal Audit
Requirements
Question 4
Beginning in 2026, programs must conduct an internal audit each calendar year to
confirm what percentage of compliance with the technical requirements and synoptic
operative reporting requirements of Standards 5.3–5.6?
A) 70%
B) 75%
C) 80%
D) 90%
Correct Answer: C
Rationale: Beginning in 2026, programs must conduct an internal audit each calendar
year to confirm 80% compliance with the technical requirements and synoptic operative
reporting requirements of Standards 5.3–5.6. This represents a significant quality
assurance requirement for accredited cancer programs.
Question 5
By what date are programs expected to develop the protocol and initiate the process for
internal audits of Standards 5.3–5.6?
, A) January 1, 2025
B) January 1, 2026
C) July 1, 2026
D) January 1, 2027
Correct Answer: B
Rationale: Starting January 1, 2026, programs are expected to develop the protocol and
initiate the process for internal audits of Standards 5.3–5.6. This implementation timeline
ensures programs have adequate time to establish compliant audit processes.
Question 6
Which of the following statements accurately describes the compliance pathway for
Standards 5.3–5.6 for 2026 site visits?
A) Programs must achieve 100% compliance with all technical requirements
B) An alternative compliance pathway is available for 2024, 2025, and 2026 site visits
C) Programs are exempt from Standards 5.3–5.6 until 2027
D) Only academic medical centers must comply with Standards 5.3–5.6
Correct Answer: B
Rationale: There is a temporary alternative pathway for compliance with Standards 5.3–
5.6 for 2024, 2025, and 2026 site visits. A site may use this pathway to be fully compliant
with Standards 5.3–5.6 at its next site visit. The alternative pathway provides flexibility
while programs work toward full compliance.
Question 7
Effective January 1, 2026, what change applies to the use of fillable PDF forms for the
synoptic requirements of CoC Standards 5.3–5.6?
A) Fillable PDF forms remain compliant for all cases
B) Fillable PDF forms will no longer be compliant
C) Fillable PDF forms are required for all cases
D) Fillable PDF forms are optional
