NCRA’s Education Department has prepared these FAQs to help potential cancer registrars understand the criteria needed to become a registrar with the goal of earning the Certified Tumor Registrar (CTR) credential.

NCRA’s Council on Certification is the best resource for questions about the CTR Exam, including exam content, exam dates and locations, and eligibility requirements. Questions about the exam can be addressed by visiting the CTR Exam webpage.

What is a cancer registrar?
Cancer registrars are data information specialists that capture a complete history, diagnosis, treatment, and health status for every cancer patient in the U.S. The data provide essential information to researchers, healthcare providers, and public health officials to better monitor and advance cancer treatments, conduct research, and improve cancer prevention and screening programs.

What is a Certified Tumor Registrar (CTR)?
“CTR” stands for Certified Tumor Registrar. Most hospitals and central cancer registries require their cancer registrars to have the CTR credential. The credential demonstrates a requisite knowledge and professional competence needed within the cancer registry field. The CTR credential is nationally recognized in the recruitment and retention of registry personnel. Individuals may be hired without having the CTR credential, though most employment opportunities do ask for it.

How do you earn the CTR credential?
The CTR credential is earned by successfully completing the CTR exam with a passing score. CTRs maintain the credential by completing 20 continuing education hours every two years. Cancer registrars who have earned the CTR credential earn approximately $25,000 more than non-credentialed cancer registrars.

What are the qualifications needed to take the CTR exam?
Candidates must meet education and experience requirements to be eligible to take the CTR exam. There are three eligibility paths (A1, A2, and B). They are detailed below and outlined in the CTR Exam Eligibility Chart.

To determine the best path for you, start by answering these questions.

Do you have less than 60 college credit hours?
Individuals who have not completed an Associate Degree and have little college coursework can enroll in an Associate Degree in Cancer Registry Management Program. This is Path A-1.

  • Successful completion of an NCRA-Accredited Associate Degree Program
  • Successful completion of 160-hour practicum under a CTR’s supervision.

Do you have an Associate Degree (in any field) or the equivalent of 60 college credit hours?
Individuals could reach the 60 college-credit hour minimum by supplementing college credits earned at NCRA-Accredited Cancer Registry Management Certificate Program. This is Path A-2.

  • Successful completion of an NCRA-Accredited Certificate Program, earning college credits.
  • Successful completion of 60 college credit hours.
  • Successful completion of 160-hour practicum under a CTR’s supervision.

Are you already working in a cancer registry and want to earn the CTR credential?
In order to be eligible to take the CTR exam under Path B, you must meet the following criteria:

  • Successful completion of Associate Degree in any field or the equivalent of 60 college credit hours.
  • Successful completion of two semesters (six total college credit hours) in Human Anatomy and Human Physiology. Grade of C or better is required. Read the A&P Fact Sheet for more information on what courses qualify.
  • 1,950 hours (equal to one year full-time) experience in the cancer registry field.

What is the NCRA-Accredited Cancer Registry Management (CRM) Formal Education Program?
NCRA accredits both Associate Degree Programs and Certificate Programs in Cancer Registry Management. These accredited programs follow standards set by NCRA’s Formal Education Program Review Committee. The curriculum content is consistent in all the NCRA accredited programs, but may differ according to the schedules (semester, rolling admission), tuition (in-state, out-of-state), and type of instruction (self-directed online or classroom/online instructor-led). In addition to NCRA accredited programs at community colleges, NCRA offers a self-directed, online certificate in Cancer Registry Management through the American Health Information Management Association (AHIMA). Review the complete list of NCRA-Accredited Formal Education Programs. If you have additional questions about NCRA educational programs, email Mary Maul or call her at 703-299-6640 Ext. 314.

Are there prerequisites required for NCRA-Accredited Programs?
The certificate programs require four prerequisites: Human Anatomy and Physiology I, Human Anatomy and Physiology II, Medical Terminology, and Computers in Healthcare. The specifications of the four prerequisites are listed at the end of these FAQs. A course is defined as a minimum of three college credit hours. Successful completion is defined as having earned a grade of “C” or better; course auditing is not accepted. 

IMPORTANT:  The four prerequisites are required for candidates seeking to enroll in an NCRA-Accredited Certificate Program. There are NO exceptions. Work experience is NOT a substitute for meeting the prerequisite requirements.

Students enrolled in an NCRA-Accredited Certificate Program at community colleges will be required to provide documentation to the school that they have completed the prerequisites prior to admission to the program. The school will accept documentation of the prerequisites according to the school’s policies and procedures. Check with the school prior to submitting your documentation to ensure it will be accepted.

Are prerequisite requirements different for students enrolled in the NCRA-AHIMA Certificate Program?
If you plan to enroll in the NCRA/AHIMA Cancer Registry Management Certificate Program and need the prerequisites, you may take the following AHIMA online courses: Computer Basics in Healthcare; Anatomy and Physiology; Pathophysiology and Pharmacology; and Medical Terminology. NCRA has determined that these courses meet the prerequisite requirements for the NCRA/AHIMA Certificate Program, and the NCRA Council on Certification will accept these prerequisites to fulfill the CTR exam requirement for NCRA/AHIMA certificate students ONLY. All CTR exam candidates who completed the NCRA/AHIMA Certificate Program will be required to submit either a transcript from the college or university where they completed the four prerequisites or submit AHIMA’s Certificates of Completion indicating successful completion of the prerequisites. If one cannot provide a transcript or the certificates, the application will be denied.

IMPORTANT: Only students enrolled in the NCRA/AHIMA Certificate Program can use the AHIMA online prerequisite courses to meet the requirement. Candidates pursuing eligibility through Route B cannot take the AHIMA online A&P courses to meet the two semesters of Human Anatomy and Human Physiology. Please see the A&P Fact Sheet.

I am candidate who has been educated abroad, and I am not sure if my international coursework will meet the prerequisite requirements.
If you would like your education reviewed and your eligibility determined by a member of the Council on Certification, complete the CTR Exam Eligibility Determination Form in its entirety and submit it via one of the methods noted on the form. Please allow 6-8 weeks to process.

I completed two semesters of A&P and one semester of medical terminology in my degree program. Do I have to repeat these courses to enroll in the NCRA/AHIMA Certificate Program?
If each course was college-level AND a minimum of three-credits AND you received a grade of “C” or better, then your past coursework would fulfill the prerequisite requirements for the NCRA/AHIMA Certificate Program. You will, however, need to take a three-credit, college-level course in Computers in Healthcare and earn a grade of “C” or better or take the AHIMA online course entitled “Computer Basics in Healthcare” in order to complete all the prerequisite requirements.

I completed my nursing degree in 1984. Will my A&P courses fulfill the prerequisite requirements to enroll in the NCRA/AHIMA Certificate Program?
If your courses in A&P were college-level AND totaled six-credit hours AND you received a grade of “C” or better, they fulfill the prerequisite requirements for the NCRA/AHIMA Certificate Program. (There are no expiration dates for college courses.) You will, however, need to take a three-credit, college-level course in Medical Terminology and a three-credit, college-level course in Computers in Healthcare and earn a grade of “C” or better in both classes or take the AHIMA online courses entitled “Computer Basics in Healthcare” and “Medical Terminology” in order to complete all the prerequisite requirements.

I completed a course in Computer Basics. Will that fulfill the prerequisite requirement?
No. The required computer course needs to be specific to healthcare and meet the criteria outlined in the definition provided at the end of these FAQs.

How long will it take to complete the CRM Program?
The length of time to complete an NCRA-Accredited Program depends on whether a student is enrolled in a program through a college or working in a self-directed online program.

Is there a practicum?
Yes. There is a practicum for all NCRA-Accredited Formal Education Programs. The practicum includes completion of specific cancer registry activities within certain parameters. Practicum activities may be completed at a cancer registry in a hospital and/or working online with an advisor at approved websites. Documentation of completion of the practicum activities must be signed by a CTR.  

Review the list of required practicum activities and related hours. 

Review the sections of the practicum that can be completed online. 

Can I begin the practicum before I finish the coursework?
No. Cancer registry facilities will not accept students for a practicum who have not completed all the coursework in an NCRA accredited Associate Degree or Certificate Program. The purpose of the practicum is to apply the theory and methodology learned in the course work; therefore, it is critical that students finish the coursework before beginning the practicum.

Does NCRA help place students in a practicum?
NCRA-Accredited Programs at colleges will place students for practicum activities. Many of the colleges will have affiliation agreements with facilities to assist with placement.  

Students in the NCRA/AHIMA Certificate Program are solely responsible for ensuring the practicum is completed. NCRA can help students in finding a facility for practicum activities but cannot guarantee placement. NCRA recommends students do the following:  

  • Submit an online Independent Clinical Advisor (ICA) request to be matched with one of NCRA’s ICAs. These advisors work online with students to complete some of the practicum activities at approved web sites. 
  • Join your state association of cancer registrars and network with members. This is best way to find a registry for your clinical practicum, since members know of facilities in the area that are willing to help.
  • Search Commission on Cancer (CoC)-accredited hospitals in your city. The list of all CoC-accredited cancer programs in the country is searchable by zip code. Start by contacting the cancer registry department directly and speaking with the cancer registry manager. 

Can an exam candidate’s volunteer hours in a cancer registry allow them to complete some of the practicum activities?
Yes. Activities required for the practicum can be completed while serving in a cancer registry as a volunteer. In fact, sometimes it is easier to secure the practicum as a volunteer, rather than an intern, since there is often less paperwork and fewer legal issues for volunteers than for formal interns.

How do I learn more about the CTR credential?
Go to the CTR Exam webpage to learn more about the exam and download the current CTR Exam Handbook & Application. The exam is offered three times a year and details on the exam dates, application deadlines, and exam locations can be found on the CTR Exam webpage.  

Prerequisite Definitions
NCRA-Accredited Certificate Programs require the successful completion of four prerequisites. The prerequisites must be college-level courses taken for credit or the equivalent as approved by NCRA’s Formal Education Program Review Committee. The prerequisites include: Computers in Healthcare; Human Anatomy and Physiology I; Human Anatomy and Physiology II; and Medical Terminology. A course is defined as three college credit hours. Successful completion is defined as having earned a grade of C or better; course auditing is not accepted.

Computers in Healthcare
The Computers in Healthcare course should provide a general overview of computers and the Internet and the role each has played in healthcare and will play in the future. Students should learn the basics of hardware and software and should gain a general understanding of the most commonly used applications in healthcare. The course should include an introduction to Health Information Management (HIM) applications, data quality, storage and retrieval, and clinical information systems.

Human Anatomy and Physiology I and Human Anatomy II
Human Anatomy and Physiology courses should include the study of the structures of the human body and how the systems within the body support its function. Areas of study should include bones, muscles, tissues, and supportive systems that promote life in the body. The course should also include information on human physiology, which is the study of the normal mechanical, physical, and biochemical functions of the human body, including the cells, organs, and human systems. The curriculum should also address physiology/pharmacology with an emphasis placed on the characteristics of the disease processes affecting the human body (i.e. cancer). It should also include the study of causes, diagnosis, and treatment of disease as well as an understanding of the basic principles of pharmacology. Download the detailed A&P Fact Sheet.

Medical Terminology
The Medical Terminology course should cover medical terminology, symbols, abbreviations, and the application language in the field of healthcare. The focus should be on the study of medical terms through word origin and structure. The course should also include the language of surgical and diagnostic procedures as well as medical specialties.