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Person with cancer—most valid basis of diagnosis of a cancer, code N

Identifying and definitional attributes

Metadata item type:Help on this termData Element
Short name:Help on this termMost valid basis of diagnosis of cancer
METeOR identifier:Help on this term270181
Registration status:Help on this termHealth, Superseded 07/12/2011
Definition:Help on this termThe most valid basis of diagnosis of cancer, as represented by a code.
Data Element Concept:Person with cancer—most valid basis of diagnosis of a cancer

Value domain attributes

Representational attributes

Representation class:Help on this termCode
Data type:Help on this termNumber
Format:Help on this termN
Maximum character length:Help on this term1
Permissible values:Help on this term
ValueMeaning
0Death certificate only: Information provided is from a death certificate
1Clinical: Diagnosis made before death, but without any of the following (codes 2-7)
2Clinical investigation: All diagnostic techniques, including x-ray, endoscopy, imaging, ultrasound, exploratory surgery (e.g. laparotomy), and autopsy, without a tissue diagnosis
4Specific tumour markers: Including biochemical and/or immunological markers that are specific for a tumour site
5Cytology: Examination of cells from a primary or secondary site, including fluids aspirated by endoscopy or needle; also includes the microscopic examination of peripheral blood and bone marrow aspirates
6Histology of metastasis: Histological examination of tissue from a metastasis, including autopsy specimens
7Histology of a primary tumour: Histological examination of tissue from primary tumour, however obtained, including all cutting techniques and bone marrow biopsies; also includes autopsy specimens of primary tumour
8Histology: either unknown whether of primary or metastatic site, or not otherwise specified
Supplementary values:Help on this term
9Unknown.

Collection and usage attributes

Guide for use:Help on this term

CODES 1 - 4

Non-microscopic.

CODES 5 - 8

Microscopic.

CODE 9

Other.

Comments:Help on this termIn a hospital setting this metadata item should be collected on the most valid basis of diagnosis at this admission. If more than one diagnosis technique is used during an admission, select the higher code from 1 to 8.

Data element attributes

Collection and usage attributes

Guide for use:Help on this term

The most valid basis of diagnosis may be the initial histological examination of the primary site, or it may be the post-mortem examination (sometimes corrected even at this point when histological results become available). In a cancer registry setting, this metadata item should be revised if later information allows its upgrading.

When considering the most valid basis of diagnosis, the minimum requirement of a cancer registry is differentiation between neoplasms that are verified microscopically and those that are not. To exclude the latter group means losing valuable information; the making of a morphological (histological) diagnosis is dependent upon a variety of factors, such as age, accessibility of the tumour, availability of medical services, and, last but not least, upon the beliefs of the patient.

A biopsy of the primary tumour should be distinguished from a biopsy of a metastasis, e.g., at laparotomy; a biopsy of cancer of the head of the pancreas versus a biopsy of a metastasis in the mesentery. However, when insufficient information is available, Code 8 should be used for any histological diagnosis. Cytological and histological diagnoses should be distinguished.

Morphological confirmation of the clinical diagnosis of malignancy depends on the successful removal of a piece of tissue that is cancerous. Especially when using endoscopic procedures (bronchoscopy, gastroscopy, laparoscopy, etc.), the clinician may miss the tumour with the biopsy forceps. These cases must be registered on the basis of endoscopic diagnosis and not excluded through lack of a morphological diagnosis.

Care must be taken in the interpretation and subsequent coding of autopsy findings, which may vary as follows:

a) the post-mortem report includes the post-mortem histological diagnosis (in which case, one of the Histology codes should be recorded instead);

b) the autopsy is macroscopic only, histological investigations having been carried out only during life (in which case, one of the Histology codes should be recorded instead);

c) the autopsy findings are not supported by any histological diagnosis.

Source and reference attributes

Origin:Help on this term

International Agency for Research on Cancer

International Association of Cancer Registries

Relational attributes

Related metadata references:Help on this term

Supersedes Most valid basis of diagnosis of cancer, version 1, DE, NHDD, NHIMG, Superseded 01/03/2005.pdf (47.0 KB)

Has been superseded by Person with cancer—most valid basis of diagnosis of a cancer, code N Health, Standard 07/12/2011

Implementation in Data Set Specifications:Help on this term
All attributes +

Breast cancer (Cancer registries) DSS Health, Superseded 01/09/2012

Cancer (clinical) DSS Health, Superseded 07/12/2005

DSS specific attributes +

Cancer (clinical) DSS Health, Superseded 06/03/2009

DSS specific attributes +

Cancer (clinical) DSS Health, Superseded 22/12/2009

DSS specific attributes +

Cancer (clinical) DSS Health, Superseded 07/12/2011

DSS specific attributes +
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