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The Histology Content Quality Group aims to ensure SNOMED CT content in <<108369006 |Neoplasm (morphologic abnormality)| is accurate and representative of prevailing scientific and medical understanding as reflected in the WHO Atlas of Tumors 5^th edition (i.e., The Blue Book). 

SNOMED CT content created and used to represent morphologic abnormalities as observed by the pathologist are essential for patient care, public health and research.  In particular, concepts << 52988006 |Lesion (morphologic abnormality)| are used broadly to define disorders, and concepts << 108369006 |Neoplasm (morphologic abnormality)| are used to define cancer disorders and used by pathologists to indicate the type of neoplasm assessed during microscopic evaluation.  In conjunction with the International Classification of Diseases – Oncology (ICD-O), the concepts can be used to bind observations made in the context of clinical care using SNOMED CT with epidemiologic classifications for cancer registry population, specifically ICD-O.  Unfortunately, current SNOMED CT content relevant to this area of medicine ( 108369006 |Neoplasm (morphologic abnormality)|) is out of date and contains concepts that are ambiguous, not modeled consistently, and do not represent prevailing cancer pathology knowledge as represented in the World Health Organization Tumor Atlas (i.e., the Blue Book).  Furthermore, SNOMED CT mapping to ICD-O is based on ICD-O-3.1 which is obsolete.  The ICD-O system is currently operating on ICD-O-3.2, which is “out of numbers” for new concepts, and is being replaced by ICD-O-4 within the next year.

Quality and currency issues in SNOMED CT content << 108369006 |Neoplasm (morphologic abnormality)| diminishes the value of SNOMED CT for use in the cancer domain (e.g., pathology practice, national registries, EHR data representation). It is necessary, therefore, to invest resources to update and improve SNOMED CT content in this part of the terminology so that SNOMED CT represents current and valid medical concepts for use in clinical care.  Updating SNOMED CT content to current pathology standards as contained in the most recent version of the Blue Book (i.e., 5^th edition) and mapping to ICD-O-4 will ensure both clinical relevancy as well as support a reliable “hand-off” from clinical terminologies to registry, epidemiologic terminologies. 

The Histology Quality (HQ) Project group was formed to address this content area in SNOMED CT. The objectives of the HQ project are:

1. Bring SNOMED CT content << 108369006 |Neoplasm (morphologic abnormality)| up to date with WHO Tumor Atlas (Blue Book) 5^th Edition
   
   
2. Update descriptions to current, accepted terminology (i.e., naming of histology types) 
   
   
3. Revise |ISA| relationships of histology concepts to reflect proper morphology lineage to support reliable data representation and analytics.
   
   
4. Ensure up-to-date mapping between ICD-O-4 and SNOMED CT,
   
   
5. Ensure validity and modeling of SNOMED CT concepts using concepts << 108369006 |Neoplasm (morphologic abnormality)| as defining attributes. 

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