Incidence and mortality estimates
The definitions of the 39 cancer entities used for the 2022 incidence and mortality estimates - classified according to the International Classification of Diseases, 10th revision (ICD-10).
Long-term estimates
The definitions of the 39 cancer entities used for the long-term estimates of incidence and mortality - classified according to the International Classification of Diseases, 10th revision (ICD-10).
Incidence and mortality historical data
The definitions of the 68 cancer entities used for historical incidence - classified according to the International Classification of Diseases for Oncology, third edition (ICD-O-3).
These cancer entities may differ from the ones used elsewhere, although the differences are small for most cancer entities. The aim of these changes is to have comparable selections for all cancer registries, especially for survival as inclusion or exclusion of certain morphologic codes may influence the outcome.
There are three main reasons for the implemented changes:
1. Introduction of the ICD11
In the past, cancer entities were based on the International Classification of Diseases (ICD), initially the 9th edition (ICD9), later the 10th edition (ICD10). Although ICD11 is not much used yet, there are some important improvements in ICD11. An example is that all mesenchymal tumours (sarcomas) are in a separate entity group, in the same way as haematological malignancies have traditionally been separate entities, not included in the entity of the organ of origin. This means that in ECIS the mesenchymal tumours are not anymore combined with epithelial cancers in one cancer entity. For example, ‘stomach’ is now renamed ‘carcinoma of stomach’ and only includes epithelial cancers, while sarcoma of the stomach is included in ‘sarcoma of soft tissues and viscera’. This also overcomes differences in coding practice. For example, a sarcoma in the lung may be coded as ‘lung’ (C34.9) or ‘soft tissues of the thorax’ (C49.3). In the past, this would result in two different entities (‘lung’ and ‘soft tissue’), but now both are in the same entity (‘sarcoma of soft tissues and viscera’).
2. Alignment with the TNM and the clinical perspective
The TNM Classification of malignant tumours sometimes differs from ICD-O. For example, base of tongue is considered a subsite of the oropharynx in the TNM and in clinical practice. Neuroendocrine tumours of the gastro-intestinal tract have a separate TNM classification and are therefore not combined with carcinomas of the gastro-intestinal tract. Consequently, base of tongue (C01) is included in the ‘carcinoma of the oropharynx’ entity and not in ‘carcinoma of the oral cavity’. A separate entity was introduced for ‘gastro-entero-pancreatic neuroendocrine tumour (GEP-NET)’. Besides, cancer entities were defined for adnexal and skin appendage neoplasm, mucosal melanoma, and melanoma of the conjunctiva and uvea. More entities will be defined in the future.
3. Historical changes in behaviour codes
Over time, several changes in the behaviour codes of some specific morphologies have been made in ICD-O. As not all registries used the same date of introduction of this change, it was not possible to use a clear cut-off date for inclusion or exclusion of a certain morphology code in ECIS. Therefore we used the following principles:
- if the behaviour was changed from malignant (/3) to non-malignant (/0 or /1), the morphology was not included, irrespective of the behaviour code, except for pilocytic astrocytoma (9421);
- if the behaviour was changed from non-malignant (/0 or /1) to malignant (/3), the morphology was included, irrespective of the behaviour code. Examples are: neuro-endocrine tumours, stromal tumours, thymoma, T/NK-LGL and paraganglioma.
Childhood incidence historical data
List of the childhood diagnostic groups and subgroups - according to the International Classification of Childhood Cancer, third edition (ICCC-3).
Survival estimates
The definitions of the 43 cancer entities used in the survival estimates - classified according to the International Classification of Diseases for Oncology, third edition (ICD-O-3).
Prevalence estimates
The definitions of the 33 cancer entities used in prevalence estimates - classified according to the International Classification of Diseases for Oncology, third edition (ICD-O-3).