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Free ODS Practice Questions

10 free, exam-style Oncology Data Specialist (ODS) practice questions with answers and explanations. No signup required. Work through them below, then take the full free ODS practice test to study every exam domain.

These 10 free ODS questions are organized by exam domain, so you can see how each part of the Oncology Data Specialist blueprint is tested. Reveal the answer and explanation under each question.

Domain 1: Legal and Ethical Aspects in the Cancer Registry Profession 17% of exam

Question 1

A hospital cancer registrar receives a request from a university researcher to access identified cancer registry data for a population-based study on racial disparities in breast cancer outcomes. The researcher states the study has been funded by a federal grant. Before releasing any identified data, which of the following is MOST required?

  1. Written consent from each patient whose data will be included in the study
  2. Approval or waiver of authorization from an Institutional Review Board (IRB)
  3. Authorization from the hospital's Chief Medical Officer only
  4. Confirmation that the researcher holds an active ODS credential
Show answer & explanation

Correct answer: B - Approval or waiver of authorization from an Institutional Review Board (IRB)

Question 2

A hospital pathology department transmits cancer diagnosis data to the state central cancer registry as required by state law. A patient whose data is included contacts the hospital's privacy officer and requests that their cancer diagnosis NOT be reported to the state registry. Under HIPAA and state cancer reporting law, what is the correct course of action?

  1. Honor the patient's request; HIPAA gives patients the right to restrict all disclosures of their health information
  2. Continue reporting; the HIPAA public health activities exception permits mandatory cancer reporting without patient authorization
  3. Remove the patient's data from future submissions but retain the data already sent
  4. Report the case using de-identified data only, removing all 18 HIPAA identifiers before transmission
Show answer & explanation

Correct answer: B - Continue reporting; the HIPAA public health activities exception permits mandatory cancer reporting without patient authorization

Domain 2: Cancer Registry Operations 25% of exam

Question 3

A cancer registrar reviews annual quality metrics for a CoC-accredited hospital cancer program and finds the following results: case completeness 99%, lifetime follow-up rate 88%, abstracting timeliness 95% within 6 months, and DCO ratio 1.2%. Which metric fails to meet the CoC standard?

  1. Case completeness of 99%
  2. Lifetime follow-up rate of 88%
  3. Abstracting timeliness of 95% within 6 months
  4. DCO ratio of 1.2%
Show answer & explanation

Correct answer: B - Lifetime follow-up rate of 88%

Question 4

A pathology report for a brain lesion reads: "Findings are consistent with meningioma, WHO Grade I." The tumor is classified as benign (behavior /0). At a CoC-accredited hospital, how should the cancer registrar handle this case?

  1. Do not abstract; benign tumors are never reportable to cancer registries
  2. Abstract the case; non-malignant CNS tumors are reportable at CoC-accredited programs
  3. Place the case in the suspense file until the tumor progresses to malignant
  4. Abstract the case only if the state central registry specifically requests it
Show answer & explanation

Correct answer: B - Abstract the case; non-malignant CNS tumors are reportable at CoC-accredited programs

Domain 3: Cancer Registry Data Identification 25% of exam

Question 5

A 58-year-old male presents with an elevated serum PSA of 8.2 ng/mL. A transrectal ultrasound-guided core needle biopsy of the prostate reveals adenocarcinoma in 4 of 12 cores. The pathologist assigns a Gleason score of 3+4=7. Using the AJCC 8th Edition Grade Group system, what Grade Group corresponds to this Gleason score?

  1. Grade Group 1
  2. Grade Group 2
  3. Grade Group 3
  4. Grade Group 4
Show answer & explanation

Correct answer: B - Grade Group 2

Question 6

A lung mass biopsy shows a malignant epithelial neoplasm. Immunohistochemistry reveals the tumor cells are positive for TTF-1 and CK7, and negative for CK20 and p40. Which histologic type is MOST consistent with this immunophenotype?

  1. Squamous cell carcinoma of the lung
  2. Adenocarcinoma of the lung
  3. Small cell carcinoma of the lung
  4. Metastatic colorectal adenocarcinoma to the lung
Show answer & explanation

Correct answer: B - Adenocarcinoma of the lung

Domain 4: Cancer Registry Coding and Abstraction 33% of exam

Question 7

A patient is diagnosed with infiltrating duct carcinoma of the right breast at your hospital on March 5. She receives neoadjuvant chemotherapy at your facility from March 20 through June 15, followed by a right modified radical mastectomy on July 10 at your facility. Final surgical pathology shows residual invasive carcinoma. Which AJCC staging prefix should be applied to the pathologic T and N classifications?

  1. c (clinical prefix, since chemotherapy was given before surgery)
  2. p (pathological prefix, since the primary tumor was surgically resected)
  3. y (post-neoadjuvant therapy prefix, since systemic treatment preceded surgical resection)
  4. r (recurrence prefix, since residual disease was found after chemotherapy)
Show answer & explanation

Correct answer: C - y (post-neoadjuvant therapy prefix, since systemic treatment preceded surgical resection)

Question 8

A 62-year-old woman is diagnosed with invasive ductal carcinoma (IDC) of the left breast in February 2025. In September 2025, she is diagnosed with invasive lobular carcinoma (ILC) of the same left breast. According to the SEER Solid Tumor Rules for Breast, how should these two tumors be abstracted?

  1. Abstract as one primary; both are carcinomas arising in the same breast
  2. Abstract as two primaries; invasive ductal and invasive lobular are different histologic types in the same breast
  3. Abstract as one primary; sequential tumors in the same breast within 12 months are always a single primary
  4. Abstract as two primaries; any tumor diagnosed more than 60 days after the first is always a new primary
Show answer & explanation

Correct answer: B - Abstract as two primaries; invasive ductal and invasive lobular are different histologic types in the same breast

Question 9

A patient is diagnosed with adenocarcinoma of the sigmoid colon at an outside hospital. He is referred to your facility, where he undergoes a sigmoid colectomy and receives adjuvant chemotherapy. No prior treatment was administered at the referring facility. What is the correct Class of Case code for this patient at your facility?

  1. Class 00 - Diagnosed and treated at your facility
  2. Class 10 - Diagnosed at another facility, all or part of first course of treatment at your facility
  3. Class 20 - Diagnosed at your facility, treated elsewhere
  4. Class 30 - Diagnosed at another facility, no first course of treatment at your facility
Show answer & explanation

Correct answer: B - Class 10 - Diagnosed at another facility, all or part of first course of treatment at your facility

Question 10

A cancer registrar is abstracting a case and encounters the following sequence of events: chest X-ray on January 3 shows a suspicious lung mass; CT scan on January 10 confirms a 3.2 cm mass in the right upper lobe; CT-guided core needle biopsy on January 22 reveals squamous cell carcinoma; right upper lobectomy on February 15 confirms squamous cell carcinoma. What is the correct Date of Diagnosis?

  1. January 3 - the date of the first suspicious imaging finding
  2. January 10 - the date the CT scan confirmed the mass
  3. January 22 - the date of the first positive tissue diagnosis
  4. February 15 - the date of definitive surgical resection
Show answer & explanation

Correct answer: C - January 22 - the date of the first positive tissue diagnosis

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