Represents a health professional’s conclusions and working assumptions that will guide treatment of the patient.

Data Element

Information from the submission form

Cancer Staging (AJCC TNM)
The AJCC Cancer Staging System describes the severity of an individual's cancer based on the magnitude of the original (primary) tumor as well as on the extent cancer has spread in the body. Understanding the stage of the cancer helps doctors to develop a prognosis and design a treatment plan for individual patients. The AJCC Cancer Staging System classifies cancers by the size and extent of the primary tumor (T), involvement of regional lymph nodes (N), and the presence or absence of distant metastases (M), supplemented in recent years by evidence-based prognostic and predictive factors. There is a T,N,M staging algorithm for cancers of virtually every anatomic site and histology, with the primary exception of pediatric cancers. The three categories—T, N, and M—and the prognostic factors collectively describe, with rare exceptions, the extent of tumor, including local spread, regional nodal involvement, and distant metastasis. It is important to stress that each component (T, N, and M) is referred to as a Category. The term stage is used when T, N, and M and cancer site–specific required prognostic factors are combined. The Criteria for T, N, and M are defined separately for cancers in different anatomic locations and/or for different histologic types.


Disease staging is critical…

Disease staging is critical to oncology.  Use cases include: * Clinicians document disease staging (using clinical assessments that can be based on observations and/or diagnostic findings) as an important means of stratifying patients by disease severity and expected outcomes. Clinicians value disease staging, leveraging it as a means to link to standards of care. * It enhances communications and decision-making between physicians, patients and stakeholders. Disease staging enables appropriate interventions based on the different stage of disease. * Clinical management guidelines, held as standard of care, are oftentimes based on disease stages. EHRs or apps can use the “disease stage” and “disease staging system” to trigger appropriate clinical decision support to enhance patient care. * Improve processes related with clinical trials: ---- The ICAREdata Project is a trailblazing initiative to support the collection of high quality real-world data to enable oncology research. Being able to draw on the cancer disease stage and disease staging system would facilitate this endeavor. ---- The Integrated Trial Matching for Cancer Patients and Providers project endeavors to develop open data standards and open APIs to enable interoperable, scalable, and accessible clinical trial matching services . * Additionally, national patient registries (see examples in the stakeholder section below) that are able to record disease stage are then able to run big data analytics and trigger population health measures to improve associated patient outcomes on a broader scale. We had made prior supportive comments for Disease Stage/Staging System Data Elements (file attached below). This submission is made on behalf of CodeX (Common Oncology Data Elements eXtensions), a member-driven HL7 FHIR Accelerator community of professional medical societies, health systems, industry and others seeking to achieve interoperability via the mCODE (minimal Common Oncology Data Elements) standard in order to drive step-change improvements in cancer patient care and research.  

Disease Staging _ USCDI Version 3 Proposal.docx

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