Introduction

Content in this project is developed specifically for reporting tissue examination observations of malignant neoplasms performed by the surgical pathologist (histopathologist) for purposes of tumor staging, structured pathology case reporting, patient prognosis, registry population and research.  This project began in 2014 as part of the Pathology and Laboratory Medicine special interest group, the Observables working group and terminology research and development efforts at the University of Nebraska Medical Center in the United States.  

Structured reporting of histopathology examination of cancerous tissue is well supported and documented by the medical and scientific communities internationally.   Multiple professional associations in SNOMED member nations publish and employ cancer reporting protocols.  These include the College of American Pathologists - CAP (Canada, United States), the Royal College of Pathology - RC Path (United Kingdom), the Royal College of Pathology Australasia - RCPA (Australia, New Zealand), the Swedish Society of Pathology, PALGA (the Netherlands) and the International Collaborative on Cancer Reporting - ICCR (multinational).  This project specifically addresses the terminology component of structured pathology reporting data elements defined by these authoritative bodies and render them machine readable.

Usage Guidance

Content in this community is specific to structured cancer reporting using the synoptic style.  Synoptic style uses a defined question and a constrained (defined) value set of possible responses for each question.  Content is specific to those data elements defined by the CAP, RCPath, RCPA, PALGA, Swedish Society of Pathology and the ICCR.  Content representing synoptic questions is modeled  using the Observable entity hierarchy.  Specific guidance for use, concept modeling rational, concept template and exemplars are included in the attached documents.

Existing content is comprised of general, cancer protocol independent content, tumor specific histology observables of type and grade, surgical margins and invasion concepts for solid tumors.

Roadmap

Content development in order of objectives:

1. Solid tumor content
2. Immunohistochemistry and other biomarker content
3. Hematopoieitic cancers
4. Pediatric cancers
5. Molecular pathology
6. Cytogenetics