Change Request
 
NHS Information Authority

Data Standards Programme

Reference: Change Request 341
Version No: 1.10
Subject: Pathology - Additional Items - National Cancer Data Set
Type of Change: Revision of NHS data standards
Effective Date: Immediate
Reason for Change: Integration of the National Cancer Dataset Pathology data items into the NHS Data Dictionary

Background:

The National Cancer Data Set Project, run by the NHS Information Authority, has produced a set of data items relating to the diagnosis and management of cancer.

The purpose of the National Cancer Minimum Data Set is to advise organisations within the National Health Service on a transferable set of data. These data will meet the needs of clinical audit, assist in the generation of National Performance Indicators and will allow outcome assessment.

Data Standards to support parts of the National Cancer Data Set have been released earlier in DSCNs.

More information about the project and the Data Set can be found at:

http://www.nhsia.nhs.uk/cancer/pages/default.asp

This DSCN defines NHS data standards to support Version 4.1_ISB additional data elements for Pathology. This encompasses four additional data elements to the NHS Data Dictionary Version 2. It also takes the opportunity to clarify all the TNM data elements based on UICC coding.

Two of these elements are new classifications of the tumour invasion and the presence of metastases which are based on existing CANCER TNM STAGING classifications. This requires a new class and attribute.

The other two elements are recording who referred the pathology specimen for analysis and which organisation they are based at. This requires a change to the relationships of REQUEST FOR DIAGNOSTIC TEST as both the referring HEALTH CARE PROFESSIONAL and the referring ORGANISATION may be required to be collected.

Summary of changes:
 
Class Definitions
CANCER TNM STAGING    Change to attributes
CANCER TNM STAGING EXTENDED    New Class
HEALTH CARE PROFESSIONAL    Change to relationships
ORGANISATION    Change to relationships
REQUEST FOR DIAGNOSTIC TEST    Change to relationships
 
Attribute Definitions
CANCER TNM EXTENDED STAGE    New Attribute
 
Data Elements
CARE PROFESSIONAL CODE (REQUESTED BY)    New DataElement
M CATEGORY (FINAL PRETREATMENT)    Change to description
M CATEGORY (INTEGRATED STAGE)    Change to description
M CATEGORY (PATHOLOGICAL)    Change to description
M CATEGORY EXTENDED (PATHOLOGICAL)    New DataElement
N CATEGORY (FINAL PRETREATMENT)    Change to description
N CATEGORY (INTEGRATED STAGE)    Change to description
N CATEGORY (PATHOLOGICAL)    Change to description
ORGANISATION CODE (REQUESTED BY)    New DataElement
T CATEGORY (FINAL PRETREATMENT)    Change to description
T CATEGORY (INTEGRATED STAGE)    Change to description
T CATEGORY (PATHOLOGICAL)    Change to description
T CATEGORY EXTENDED (PATHOLOGICAL)    New DataElement
TMN CATEGORY (FINAL PRETREATMENT)    Change to description
TMN CATEGORY (INTEGRATED)    Change to description
TMN CATEGORY (PATHOLOGICAL)    Change to description
 
Diagrams
NCDS3 NATIONAL CANCER DATA SET PART 3    Change to diagram contents

Name: Barbara Fogarty
Date: 20 August 2003
Sponsor: Data and Information Standards Programme

Note: Additions shown in highlighted with a blue background. Deletions are shown using strikeout.

CANCER TNM STAGING
Change to Class: change to attributes

Attributes of this Class are:
K CANCER STAGING TYPE
K TNM TYPE
O STAGING CERTAINTY FACTOR


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    CANCER TNM STAGING EXTENDED
    Change to Class: New Class

    CANCER TNM STAGING EXTENDED

    A type of CLINICAL CLASSIFICATION.

    A classification of the spread of a cancer using extensions to the CANCER TNM STAGING classifications published by the Union Internationale Contre Cancer (UICC). The acronym TNM relates to the three categories for which codes are recorded, the categories being Tumour, Node and Metastasis.

    These classifications are used for Pathology results.

    References:
    National Cancer Data Set



    This class is also known by these names:
    Context Alias
    plural CANCER TNM STAGINGS EXTENDED

    Attributes of this Class are:
    CANCER TNM EXTENDED STAGE
    TNM TYPE

    This class has no relationships.


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      HEALTH CARE PROFESSIONAL
      Change to Class: change to relationships

      Each HEALTH CARE PROFESSIONAL
      may be related to one or more CLINICAL INVESTIGATION SERVICE PROVIDER
      may be responsible for one or more DAY CARE SESSION
      may be the dispenser of one or more DISPENSED ITEM
      may be the prescriber of one or more DRUG TREATMENT
      may be the provider of one or more GMP PRACTICE CONSULTATION
      may be the participant in one or more HEALTH CARE PROFESSIONAL INVOLVEMENT
      may be the evaluator of one or more HONOS SCORE FOR PERSON
      may be associated with one or more ITEM OF SERVICE DELIVERY ROLE
      may be the person responsible for one or more PATIENT PROCEDURE
      may be the observer of one or more PERSON OBSERVATION
      may be the issuer of one or more PRESCRIPTION
      may be related to one or more RADIOLOGY INVESTIGATION PLAN
      may be the originator of one or more REFERRAL REQUEST
      may be related as requester of one or more REQUEST FOR DIAGNOSTIC TEST
      may be related as provider to one or more REQUEST FOR DIAGNOSTIC TEST
      may be the requester of one or more REQUEST FOR DIAGNOSTIC TEST
      may be the recipient of one or more SERVICE REPORT COPY
      may be recorder of one or more SERVICE REPORT HEADER
      may be the requester of one or more SERVICE REPORT HEADER


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        ORGANISATION
        Change to Class: change to relationships

        Each ORGANISATION
        may be located at one or more ADDRESS ASSOCIATION
        may be related to one or more CLINICAL INVESTIGATION SERVICE PROVIDER
        may be the subject of one or more COMMUNITY PHARMACY SITE APPLICATION
        may be related to one or more DRUG MISUSE AGENCY
        may be related to one or more EMPLOYEE CONTRACT
        may be associated with one or more GEOGRAPHIC AREA ASSOCIATION
        may be acting as one or more HEALTH CARE PROVIDER
        may be planning or operating one or more JOINT INVESTMENT PLAN
        may be jointly associated with one or more JOINT INVESTMENT PLAN ASSOCIATION
        may be related to one or more LOCATION
        may be related to one or more MEDICAL AND DENTAL POST
        may be the commissioner within one or more NHS SERVICE AGREEMENT
        may be related to one or more NON MEDICAL AND DENTAL POST
        may be the allocator of one or more ORGANISATION IDENTIFIER
        may be identified by one or more ORGANISATION IDENTIFIER
        may be the allocator of one or more ORGANISATION IDENTIFIER
        may be related to one or more ORGANISATION REPORTING PERIOD
        may be the operator or manager of one or more ORGANISATION SITE
        may be related to one or more ORGANISATION STRUCTURE
        may be related from one or more ORGANISATION STRUCTURE
        may be the allocator of one or more PERSON IDENTIFIER
        may be connected with one or more PERSON ROLE IN ORGANISATION
        may be the place of treatment for one or more PRIOR NOTIFICATION LIST ENTRY
        may be undertaking one or more RECRUITMENT
        may be the originator of one or more REFERRAL REQUEST
        may be the requester of one or more REQUEST FOR DIAGNOSTIC TEST
        may be related as provider to one or more REQUEST FOR DIAGNOSTIC TEST
        may be related as requester of one or more REQUEST FOR DIAGNOSTIC TEST
        may be experiencing one or more RETENTION DIFFICULTY
        may be the recipient of one or more SERVICE REPORT COPY
        may be the issuer of one or more SERVICE REPORT HEADER
        may be the requester of services for one or more SERVICE REPORT HEADER
        may be subject to one or more SINGLE SEX ACCOMMODATION TARGET
        may be contacted by one or more TELE-COMMUNICATION CONTACT STRING
        may be related to one or more WRITTEN COMPLAINT


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          REQUEST FOR DIAGNOSTIC TEST
          Change to Class: change to relationships

          Each REQUEST FOR DIAGNOSTIC TEST
          K must be processed by one and only one SERVICE POINT
          may be an order to one and only one HEALTH CARE PROFESSIONAL
          or may be an order to one and only one ORGANISATION
          may be an order to one and only one ORGANISATION
          may be requested by one and only one HEALTH CARE PROFESSIONAL
          or may be requested by one and only one ORGANISATION
          may be requested by one and only one HEALTH CARE PROFESSIONAL
          may be except Category II requests from one and only one LOCATION
          may be requested by one and only one ORGANISATION
          may be related to one and only one PATIENT
          may be a request with subsequently one or more REQUEST FOR DIAGNOSTIC TEST
          may be subsequent to an original one REQUEST FOR DIAGNOSTIC TEST
          may be related to one and only one SERVICE PROVIDED
          may be initiated within one and only one SPECIALTY FUNCTION


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            CANCER TNM EXTENDED STAGE
            Change to Attribute: New Attribute

            CANCER TNM EXTENDED STAGE

            The classification of CANCER TNM STAGING EXTENDED.

            For example, the T component of CANCER TNM STAGING Lung, T4: "tumour of any size that invades any of the following: mediastinum, heart, great vessels, trachea, oesophagus ....". is extended into:

            T4(i) - tumour invades great vessel
            T4(ii) - tumour invades atrium, mediastinum or heart
            T4(iii) - tumour invades trachea
            T4(iv) - tumour invades oesophagus



            This attribute is also known by these names:
            Context Alias
            plural CANCER TNM EXTENDED STAGES


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              CARE PROFESSIONAL CODE (REQUESTED BY)
              Change to Data Element: New DataElement

              CARE PROFESSIONAL CODE (REQUESTED BY)

              Format/length: an8
              HES item:
              National Codes:
              Default Codes:  

              Notes:
              The code of the HEALTH CARE PROFESSIONAL who requests the REQUEST FOR DIAGNOSTIC TEST for suspected cancer. This is not required if the request comes from a GENERAL MEDICAL PRACTITIONER.


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                M CATEGORY (FINAL PRETREATMENT)
                Change to Data Element: change to description

                Format/length: an5
                HES item:
                National Codes:
                Default Codes:  

                This is the TNM TYPE with National Code 3. 'Metastasis component', where the CANCER STAGING TYPE is 1. 'Final pre-treatment stage'. This is the CLINICAL CLASSIFICATION CODE which classifies the absence or presence of distant metastases where the TNM TYPE is 3. Metastasis component and the CANCER STAGING TYPE is 1. Final pre-treatment stage.

                UICC (Union Internationale Contre Cancer) coding is used.



                This data element is also known by these names:
                Context Alias
                plural M CATEGORIES (FINAL PRETREATMENT)


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                  M CATEGORY (INTEGRATED STAGE)
                  Change to Data Element: change to description

                  Format/length: an5
                  HES item:
                  National Codes: Press Definition button for the National Codes
                  National Codes:
                  Default Codes:  

                  This is the TNM TYPE with National Code 3. 'Metastasis component', where the CANCER STAGING TYPE is 3. 'Integrated stage'. This is the CLINICAL CLASSIFICATION CODE which classifies the absence or presence of distant metastases where the TNM TYPE is 3. Metastasis component and the CANCER STAGING TYPE is 3. Integrated stage.

                  UICC (Union Internationale Contre Cancer) coding is used.



                  This data element is also known by these names:
                  Context Alias
                  plural M CATEGORIES (INTEGRATED STAGE)


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                    M CATEGORY (PATHOLOGICAL)
                    Change to Data Element: change to description

                    Format/length: an5
                    HES item:
                    National Codes: Press Definition button for the National Codes
                    National Codes:
                    Default Codes:  

                    This is the TNM TYPE with National Code 3. 'Metastasis component', where the CANCER STAGING TYPE is 2. 'Pathological stage'. Notes:
                    This is the CLINICAL CLASSIFICATION CODE which classifies the absence or presence of distant metastases where the TNM TYPE is 3. Metastasis component and the CANCER STAGING TYPE is 2. Pathological stage.

                    UICC (Union Internationale Contre Cancer) coding is used.



                    This data element is also known by these names:
                    Context Alias
                    plural M CATEGORIES (PATHOLOGICAL)


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                      M CATEGORY EXTENDED (PATHOLOGICAL)
                      Change to Data Element: New DataElement

                      M CATEGORY EXTENDED (PATHOLOGICAL)

                      Format/length: an9
                      HES item:
                      National Codes:
                      Default Codes:  

                      Notes:
                      This is the CLINICAL CLASSIFICATION CODE together with the CANCER TNM EXTENDED STAGE which classifies the presence of metastatic deposits of the primary tumour at distant metastatic sites where the TNM TYPE is 3. Metastasis component and the CANCER STAGING TYPE is 2. Pathological stage.

                      UICC (Union Internationale Contre Cancer) coding is used.



                      This data element is also known by these names:
                      Context Alias
                      plural M CATEGORIES EXTENDED (PATHOLOGICAL)


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                        N CATEGORY (FINAL PRETREATMENT)
                        Change to Data Element: change to description

                        Format/length: an5
                        HES item:
                        National Codes:
                        Default Codes:  

                        This is the TNM TYPE with National Code 2. 'Node component', where the CANCER STAGING TYPE is 1. 'Final pre-treatment stage'. This is the CLINICAL CLASSIFICATION CODE which classifies the absence or presence and extent of regional lymph node metastases where the TNM TYPE is 2. Node component and the CANCER STAGING TYPE is 1. Final pre-treatment stage.

                        UICC (Union Internationale Contre Cancer) coding is used.



                        This data element is also known by these names:
                        Context Alias
                        plural N CATEGORIES (FINAL PRETREATMENT)


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                          N CATEGORY (INTEGRATED STAGE)
                          Change to Data Element: change to description

                          Format/length: an5
                          HES item:
                          National Codes:
                          Default Codes:  

                          This is the TNM TYPE with National Code 2. 'Node component', where the CANCER STAGING TYPE is 3. 'Integrated stage'. This is the CLINICAL CLASSIFICATION CODE which classifies the absence or presence and extent of regional lymph node metastases where the TNM TYPE is 2. Node component and the CANCER STAGING TYPE is 3. Integrated stage.

                          UICC (Union Internationale Contre Cancer) coding is used.



                          This data element is also known by these names:
                          Context Alias
                          plural N CATEGORIES (INTEGRATED STAGE)


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                            N CATEGORY (PATHOLOGICAL)
                            Change to Data Element: change to description

                            Format/length: an5
                            HES item:
                            National Codes:
                            Default Codes:  

                            This is the TNM TYPE with National Code 2. 'Node component', where the CANCER STAGING TYPE is 2. 'Pathological stage'. This is the CLINICAL CLASSIFICATION CODE which classifies the absence or presence and extent of regional lymph node metastases where the TNM TYPE is 2. Node component and the CANCER STAGING TYPE is 2. Pathological stage.

                            UICC (Union Internationale Contre Cancer) coding is used.



                            This data element is also known by these names:
                            Context Alias
                            plural N CATEGORIES (PATHOLOGICAL)


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                              ORGANISATION CODE (REQUESTED BY)
                              Change to Data Element: New DataElement

                              ORGANISATION CODE (REQUESTED BY)

                              Format/length: an5
                              HES item:
                              National Codes:
                              Default Codes:  

                              Notes:
                              This is the ORGANISATION CODE of the ORGANISATION at which the HEALTH CARE PROFESSIONAL who requested the REQUEST FOR DIAGNOSTIC TEST for suspected cancer is based.


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                                T CATEGORY (FINAL PRETREATMENT)
                                Change to Data Element: change to description

                                Format/length: an5
                                HES item:
                                National Codes:
                                Default Codes:  

                                This is the TNM TYPE with National Code 1. 'Tumour component', where the CANCER STAGING TYPE is 1. 'Final pre-treatment stage'. This is the CLINICAL CLASSIFICATION CODE which classifies the size and extent of the primary tumour where the TNM TYPE is 1. Tumour component and the CANCER STAGING TYPE is 1. Final pre-treatment stage.

                                UICC (Union Internationale Contre Cancer) coding is used.



                                This data element is also known by these names:
                                Context Alias
                                plural T CATEGORIES (FINAL PRETREATMENT)


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                                  T CATEGORY (INTEGRATED STAGE)
                                  Change to Data Element: change to description

                                  Format/length: an5
                                  HES item:
                                  National Codes:
                                  Default Codes:  

                                  This is the TNM TYPE with National Code 1. 'Tumour component', where the CANCER STAGING TYPE is 3. 'Integrated stage'. This is the CLINICAL CLASSIFICATION CODE which classifies the size and extent of the primary tumour where the TNM TYPE is 1. Tumour component and the CANCER STAGING TYPE is 3. Integrated stage.

                                  UICC (Union Internationale Contre Cancer) coding is used.



                                  This data element is also known by these names:
                                  Context Alias
                                  plural T CATEGORIES (INTEGRATED STAGE)


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                                    T CATEGORY (PATHOLOGICAL)
                                    Change to Data Element: change to description

                                    Format/length: an5
                                    HES item:
                                    National Codes:
                                    Default Codes:  

                                    This is the TNM TYPE with National Code 1. 'Tumour component', where the CANCER STAGING TYPE is 2. 'Pathological stage'. This is the CLINICAL CLASSIFICATION CODE which classifies the size and extent of the primary tumour where the TNM TYPE is 1. Tumour component and the CANCER STAGING TYPE is 2. Pathological stage.

                                    UICC (Union Internationale Contre Cancer) coding is used.



                                    This data element is also known by these names:
                                    Context Alias
                                    plural T CATEGORIES (PATHOLOGICAL)


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                                      T CATEGORY EXTENDED (PATHOLOGICAL)
                                      Change to Data Element: New DataElement

                                      T CATEGORY EXTENDED (PATHOLOGICAL)

                                      Format/length: an9
                                      HES item:
                                      National Codes:
                                      Default Codes:  

                                      Notes:
                                      This is the CLINICAL CLASSIFICATION CODE together with the CANCER TNM EXTENDED STAGE which classifies the extent of the invasion of the tumour where the TNM TYPE is 1. Tumour component and the CANCER STAGING TYPE is 2. Pathological stage.

                                      UICC (Union Internationale Contre Cancer) coding is used.



                                      This data element is also known by these names:
                                      Context Alias
                                      plural T CATEGORIES EXTENDED (PATHOLOGICAL)


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                                        TMN CATEGORY (FINAL PRETREATMENT)
                                        Change to Data Element: change to description

                                        Format/length: an5
                                        HES item:
                                        National Codes:
                                        Default Codes:  

                                        This is the TNM TYPE with National Code 4. 'Overall TNM stage', where the CANCER STAGING TYPE is 1. 'Final pre-treatment stage'. This is the CLINICAL CLASSIFICATION CODE which classifies the combination of tumour, node and metastases into stage groupings where the TNM TYPE is 4. Overall TNM stage and the CANCER STAGING TYPE is 1. Final pre-treatment stage.

                                        UICC (Union Internationale Contre Cancer) coding is used.



                                        This data element is also known by these names:
                                        Context Alias
                                        plural TMN CATEGORIES (FINAL PRETREATMENT)


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                                          TMN CATEGORY (INTEGRATED)
                                          Change to Data Element: change to description

                                          Format/length: an5
                                          HES item:
                                          National Codes:
                                          Default Codes:  

                                          This is the TNM TYPE with National Code 4. 'Overall TNM stage', where the CANCER STAGING TYPE is 3. 'Integrated stage'. This is the CLINICAL CLASSIFICATION CODE which classifies the combination of tumour, node and metastases into stage groupings where the TNM TYPE is 4. Overall TNM stage and the CANCER STAGING TYPE is 3. Integrated stage.

                                          UICC (Union Internationale Contre Cancer) coding is used.



                                          This data element is also known by these names:
                                          Context Alias
                                          plural TMN CATEGORIES (INTEGRATED)


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                                            TMN CATEGORY (PATHOLOGICAL)
                                            Change to Data Element: change to description

                                            Format/length: an5
                                            HES item:
                                            National Codes:
                                            Default Codes:  

                                            This is the TNM TYPE with National Code 4. 'Overall TNM stage', where the CANCER STAGING TYPE is 2. 'Pathological stage'. This is the CLINICAL CLASSIFICATION CODE which classifies the combination of tumour, node and metastases into stage groupings where the TNM TYPE is 4. Overall TNM stage and the CANCER STAGING TYPE is 2. Pathological stage.

                                            UICC (Union Internationale Contre Cancer) coding is used.



                                            This data element is also known by these names:
                                            Context Alias
                                            plural TMN CATEGORIES (PATHOLOGICAL)


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                                              NCDS3 NATIONAL CANCER DATA SET PART 3
                                              Change to Diagram: Change to diagram contents


                                               NCDS3 National Cancer Data Set Part 3 


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                                                Please send enquiries about this DSCN to the mailbox of the Data and Information Standards Programme:-

                                                e-mail: disp@nhsia.nhs.uk

                                                or contact Alison Parsons of the Data and Information Standards Programme on:

                                                tel: 0121 333 0351