International Classification Of Diseases For Oncology Codes Research Articles

New Histopathological Diagnostic Terms and their Codes of the Central Nervous System (CNS) in the International Classification of Diseases for Oncology (ICD-O 3.1) and about the Turkish Version of ICD-O

International Classification of Diseases for Oncology (ICD-O), which has been used in the world since 1976 for 40 years and has been translated into many languages, emphasizing the importance of health and cancer is presented. In addition, the histopathological classification working group of central nervous system (CNS) tumors has proposed new terms and their new ICD-O codes, taking into account their genetic characteristics. Our goal is to emphasize the current importance of ICD-O. Since 2015, ICD-O has been put into practice by the Ministry of Health in Turkey. Writing of ICD-O codes is required for pathology reports. In the last 25 years, I have translated the ICD-O three times into Turkish, 1992, 2002 and 2015, serving as pathology, oncology, cancer registrars and the Ministry of Health.

The Temporal Trends in Incidence of Intra and Extrahepatic Cholangiocarcinoma in the United States and the Impact of Klatskin Tumor Classification

Background and Aims: Previous studies of cholangiocarcinoma have reported an increasing incidence of intrahepatic (ICC) and a decreasing incidence of extrahepatic (ECC) in the United States. Hilar cholangiocarcinomas (Klatskin tumors) are anatomically defined as ECC and could have affected these trends. In version 1 of the International Classification of Diseases for Oncology (ICD-O) (1973-1991), Klatskin tumors were not assigned a unique ICD-O code and may have been coded as either ICC or ECC. In ICD-O version 2 (19922000), they were assigned a unique histology code (8162/3) which was cross-referenced to ICC. ICD-O version 3 (2000-present) cross-referenced Klatskin tumors to either ICC or ECC. Thus, Klatskin tumors may have been misclassified as ICC under all versions of ICDO. We conducted this study to determine 1) the secular trends of ICC and ECC from 19922007 and 2) the potential impact of misclassification bias on these trends. Methods: Using data from the Surveillance, Epidemiology and End Results (SEER) program, age-adjusted incidence rates of ICC and ECC were calculated in two consecutive time periods (19922000, 2001-2007). Following definitions were used: ICC: topography codes C22.0 (Liver) and C22.1 (Intra-hepatic bile duct) and histology codes 8140, 8160, 8161, 8020, and 8010. ECC: topography code C24.0; histology codes 8010, 8020, 8041, 8070, 8140, 8144, 8160, 8161, 8260, 8310, 8480, 8490, and 8560. Klatskin: histology code 8162/3. We calculated the annual percent change (APC) in incidence rates, utilizing a weighted least squares method. Results: We identified 4297 patients with ICC and 2679 patients with ECC during 1992-2007. The age adjusted rates (per 100,000) for ICC excluding Klatskin tumors (i.e., true ICC rate) decreased from 1.5 during 1992-2000 to 1.4 in 2001-2007 with an APC of -0.3% (95% C.I.: 1.5, 0.8), whereas true ECC rates, including Klatskin tumors significantly increased from 0.8 to 1.1 during the same time periods with an APC of 3.3% (95% C.I.: 2.0, 4.5). The increased incidence of ECC was more pronounced in males (APC 3.6%, 95% C.I.: 2.0, 5.1), Asians and pacific islanders (APC 4.5%) and in the 65+ age group (APC 3.9%). During 1992-2000, 208/224 (93%) cases of Klatskin tumors were misclassified as ICC's. This proportion dropped to 60/144 (42%) in 2001-2007. However, even with misclassification the incidence rate for ICC (including Klatskin tumors) declined from 1.6 to 1.4 per 100,000 during the two time periods with an APC of -0.9% (95% C.I -2.1, 0.3). Conclusions: Contrary to recent data, the incidence rates of ICC in the US have remained stable during the period 1992-2007, whereas ECC rates have risen. Improved classification of Klatskin tumors may explain some but not all of these trends.

Therapeutic Efficacy of Silvestrol, a Novel Protein Translation Inhibitor, as an Anticancer Agent for Cholangiocarcinoma

Background and Aims: Previous studies of cholangiocarcinoma have reported an increasing incidence of intrahepatic (ICC) and a decreasing incidence of extrahepatic (ECC) in the United States. Hilar cholangiocarcinomas (Klatskin tumors) are anatomically defined as ECC and could have affected these trends. In version 1 of the International Classification of Diseases for Oncology (ICD-O) (1973-1991), Klatskin tumors were not assigned a unique ICD-O code and may have been coded as either ICC or ECC. In ICD-O version 2 (19922000), they were assigned a unique histology code (8162/3) which was cross-referenced to ICC. ICD-O version 3 (2000-present) cross-referenced Klatskin tumors to either ICC or ECC. Thus, Klatskin tumors may have been misclassified as ICC under all versions of ICDO. We conducted this study to determine 1) the secular trends of ICC and ECC from 19922007 and 2) the potential impact of misclassification bias on these trends. Methods: Using data from the Surveillance, Epidemiology and End Results (SEER) program, age-adjusted incidence rates of ICC and ECC were calculated in two consecutive time periods (19922000, 2001-2007). Following definitions were used: ICC: topography codes C22.0 (Liver) and C22.1 (Intra-hepatic bile duct) and histology codes 8140, 8160, 8161, 8020, and 8010. ECC: topography code C24.0; histology codes 8010, 8020, 8041, 8070, 8140, 8144, 8160, 8161, 8260, 8310, 8480, 8490, and 8560. Klatskin: histology code 8162/3. We calculated the annual percent change (APC) in incidence rates, utilizing a weighted least squares method. Results: We identified 4297 patients with ICC and 2679 patients with ECC during 1992-2007. The age adjusted rates (per 100,000) for ICC excluding Klatskin tumors (i.e., true ICC rate) decreased from 1.5 during 1992-2000 to 1.4 in 2001-2007 with an APC of -0.3% (95% C.I.: 1.5, 0.8), whereas true ECC rates, including Klatskin tumors significantly increased from 0.8 to 1.1 during the same time periods with an APC of 3.3% (95% C.I.: 2.0, 4.5). The increased incidence of ECC was more pronounced in males (APC 3.6%, 95% C.I.: 2.0, 5.1), Asians and pacific islanders (APC 4.5%) and in the 65+ age group (APC 3.9%). During 1992-2000, 208/224 (93%) cases of Klatskin tumors were misclassified as ICC's. This proportion dropped to 60/144 (42%) in 2001-2007. However, even with misclassification the incidence rate for ICC (including Klatskin tumors) declined from 1.6 to 1.4 per 100,000 during the two time periods with an APC of -0.9% (95% C.I -2.1, 0.3). Conclusions: Contrary to recent data, the incidence rates of ICC in the US have remained stable during the period 1992-2007, whereas ECC rates have risen. Improved classification of Klatskin tumors may explain some but not all of these trends.

Cancer among teenagers in Denmark, 1943-1987.

A population-based study was carried out on 3,988 tumours in teenagers (aged 10-19 years) diagnosed during the period 1943-87 in Denmark and abstracted from the files of the National Cancer Registry. In that Registry, codes for tumours were based solely on topography until the end of 1977. In order to obtain a uniform data set, coded by the system of the International Classification of Diseases for Oncology (ICD-O) now used at the Cancer Registry, all cases of teenage cancer diagnosed prior to 1978 were re-evaluated, and an ICD-O code was applied. Tumours were further aggregated into diagnostic groups using an internationally agreed scheme. The average incidence rates for all histological types combined were 136 per million for boys and 108 per million for girls, which are close to those reported in Connecticut, USA. Central nervous system tumours, leukaemia and malignant lymphomas accounted for 60% of all cancers among teenagers. An overall excess of cancers among boys was mainly due to more frequent occurrence of leukaemias, malignant lymphomas, sarcomas and germ-cell tumours. Increasing trends with time were seen for malignant lymphomas in both boys and girls and for subtypes of non-seminoma germ-cell tumour among boys aged 15-19. For other diagnostic groups, including the main group of leukaemias, the rates have remained largely unchanged, suggesting that environmental factors associated with modern society play a minor role in the aetiology of cancer among teenagers.

Incidence of childhood cancer in Denmark 1943-1984.

A population-based study was carried out on 5790 tumours in children (aged 0-14 years) diagnosed in the period 1943-1984 in Denmark. Cases were identified from the files of the high-quality National Cancer Registry in which codes for tumours were based solely on topography until the end of 1977. To achieve a uniform data set following the outlines of the International Classification of Diseases for Oncology (ICD-O) coding system used by the Cancer Registry today, all cases of childhood cancer diagnosed prior to 1978 were re-evaluated, and an ICD-O code was applied. Tumours were aggregated into diagnostic groups suitable for analysis and presentation using an internationally agreed scheme, which was designed by the Manchester Children's Tumour Registry and modified recently by the International Agency for Research on Cancer. The average incidence rates for all histological types of childhood cancer combined were 137 per million boys and 111 per million girls, which are close to those reported from the USA but higher than most of the overall figures reported from Europe. The proportions of specific tumours were similar to those observed in other industrialized countries. The well known excess of cancer cases among boys compared to girls was due mainly to the occurrence of 90% more lymphomas, 30% more leukaemias and 15% more tumours of the central nervous system (CNS) among boys. Although significant increases were seen in the subgroups of CNS neoplasms and neuroblastomas (both sexes) and of lymphomas (boys only), no overall increase in childhood cancer was observed during the 42-year period of registration. While the increase in the incidence of CNS tumours was explained at least partly by better cancer surveillance, no interpretation can be offered for the increases seen for neuroblastomas and lymphomas. Our descriptive data suggest that environmental exposures do not play any significant role in the aetiology of the majority of childhood cancers.