Lung Cancer Pathology Standards 150907 by yaohongm

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									    Lung Cancer Pathology
       Data Standards

                  Consultation Document

                                                                    September 2007

                                      National Clinical Dataset Development Programme
                                      (NCDDP)
                                      Support Team
                                      Information Services
                                      Area 74A Gyle Square
                                      1 South Gyle Crescent
                                      Edinburgh
                                      EH12 9EB

                                      Tel:      0131 275 7066
                                      Email to: NCDDPsupportteam@isd.csa.scot.nhs.uk
                                      Website: www.clinicaldatasets.scot.nhs.uk




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007
Section 1 - Overview & Background .................................................. 1

Overview ..................................................................................................................1
Lung Cancer Pathology Data Standards...............................................................2
Background to NCDDP ...........................................................................................2
Generic Data Items..................................................................................................3
Clinical Terminology ...............................................................................................3
Date Recording........................................................................................................3

Published Data Standards................................................................... 4

Generic and Previously Consulted 1 ......................................................................4

Section 2. - Lung Cancer Pathology Data Standards ....................... 5

2.1 Distance from Bronchial or Medial Excision Margin (Lung Cancer).............5
2.2 Extent of Atelectasis (Lung Cancer)................................................................5
2.3 Acinar Pattern Percentage (Adenocarcinoma) (Lung Cancer) ......................6
2.4 Papillary Pattern Percentage (Adenocarcinoma) (Lung Cancer) ..................6
2.5 Solid with Mucin Pattern Percentage (Adenocarcinoma) (Lung Cancer).....6
2.6 Bronchioloalveolar Pattern Percentage (Adenocarcinoma) (Lung Cancer).7
2.7 Central Scar (Adenocarcinoma) (Lung Cancer)..............................................7
2.8 Size of Central Scar (Adenocarcinoma) (Lung Cancer) .................................8
2.9 Invasion into Central Scar (Adenocarcinoma) (Lung Cancer).......................8
2.10 Extent of Invasion into Central Scar (Adenocarcinoma) (Lung Cancer) ....9
2.11 Extent of Local Invasion (Lung Cancer)......................................................10
2.12 Lymph Nodes Type Submitted (Lung Cancer)............................................11
2.13 Lymph Nodes Type Involved (Lung Cancer)...............................................12
2.14 Margins Involved (Lung Cancer)..................................................................13
2.15 Emphysema ...................................................................................................14
2.16 Degree of Emphysema..................................................................................14
2.17 Diffuse Parenchymal Lung Disease.............................................................14
2.18 Diffuse Parenchymal Lung Disease: Pattern of Disease Present .............15
2.19 Aetiology of Diffuse Parenchymal Lung Disease .......................................16


Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007
2.20 TNM Tumour Classification (Pathological) (Non-small Cell Carcinoma of
Lung) ......................................................................................................................17
2.21 TNM Nodal Classification (Pathological) (Non-small Cell Carcinoma of
Lung) ......................................................................................................................18
2.22 TNM Metastases Classification (Pathological) (Non-small Cell Carcinoma
of Lung)..................................................................................................................19
2.23 Grade of Differentiation (Lung Cancer) .......................................................19
2.24 Pre-Invasive Lung Lesions (Lung Cancer)..................................................20

Section 3. - Pleural Mesothelioma Pathology Data Standards ...... 21

3.1 Source of Specimen (Pleural Mesothelioma)................................................21
3.2 TNM Tumour Classification (Pathological) (Pleural Mesothelioma) ...........22
3.3 TNM Nodal Classification (Pathological) (Pleural Mesothelioma) ..............23
3.4 TNM Metastases Classification (Pathological) (Pleural Mesothelioma) .....24
3.5 Histological Diagnosis (Pleural Mesothelioma)............................................24

Appendix 1 - Working Group Membership ...................................... 25


Appendix 2 Consultation Distribution List ...................................... 26


Appendix 3 – Consultation Response (Lung Cancer) ................. 28




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007
Section 1 - Overview & Background
Overview
The Scottish Cancer Group supports the development of Lung Cancer Pathology Data
Standards for NHS Scotland in order to ensure a national approach to the collection of
pathological data items relating to cancer. The aim is to ensure inter-compatibility of
national clinical information systems, and support the implementation of an electronic
integrated health record. Cancer already has a range of individual national data sets for
audit, screening and registration and these standards build on these systems. National data
standards will support data sharing and allow secondary use of data for these purposes. A
multi-disciplinary Clinical Working Group, established in August 2006 and supported by the
National Clinical Dataset Development Programme (NCDDP) Support Team in Information
Services Division (ISD), carried out the development of these cancer data standards.

    The Lung Cancer Pathology Data Standards will:

       Define common data items recommended for collection in a wide variety of
       clinical settings

       Support the exchange of patient information between healthcare providers

       Support the consistent recording of patient information throughout NHS
       Scotland


It is important to emphasise that these are data standards rather than a dataset. This
means that the individual data items included in this document are not required to be
recorded together in a single clinical information system. However where it is considered
appropriate to record a particular data item as part of the record of care, the information
should be recorded in accordance with the nationally agreed standard.

We are now asking for feedback from the wider clinical community in order to ensure that
these data standards are fit for purpose and ready for inclusion in the national Health and
Social Care Data Dictionary. We invite all interested organisations and individuals to take
part in this consultation by completing the attached Consultation Response Form and then
returning it to NCDDPsupportteam@isd.csa.scot.nhs.uk. Comments on all or a part of the
document are welcome.

Some background information on the NCDDP and Lung Cancer Pathology Data Standard
development can be found below. If you have any further queries, please go to our website
or contact NCDDPsupportteam@isd.csa.scot.nhs.uk.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007         1
Lung Cancer Pathology Data Standards

The membership of the Cancer Pathology Data Standards Clinical Working Group is shown
in appendix 1. This group agreed the inclusion of individual data items using the following
criteria:

   1. Is the data item one that would reasonably be expected to be collected for all lung
      cancer pathology?
   2. Is the data item necessary for the healthcare of cancer patients?
   3. Is the data item one that is likely to be shared among health care professionals?

Once consultation is complete the Lung Cancer Pathology Data Standards will be submitted
to the NCDDP Programme Board for formal approval as a national standard, and then
passed to the eHealth National Clinical Information Steering Group and the NHS Scotland
Information Standards Group for endorsement. Once approved the Lung Cancer Pathology
Data Standards will be freely and widely available through publication in the Health and
Social Care Data Dictionary (www.datadictionary.scot.nhs.uk). As far as possible they are
UK compatible. It is expected that the Lung Cancer Pathology Data Standards will be
implemented within existing and emerging national clinical information systems and
commercially procured national products, as well as being available to commercial
developers to ensure the ability of their systems to support national information
requirements.

Background to NCDDP
The National Clinical Dataset Development Programme (NCDDP) supports clinicians to
develop sets of interoperable national datasets to facilitate the implementation of the
integrated care records across NHS Scotland.

These standards will:
• Support direct patient care, by reflecting current best practice guidance
• Facilitate effective communication between health care professionals
• Improve data quality and support secondary data requirements where possible including
   data to support clinical governance
• Be freely and widely available through publication in the web based Health & Social Care
   Data Dictionary
• Incorporate agreed national clinical definitions and implement national terminology
• Be UK compatible where possible

The programme was established by the Chief Medical Officer in 2003 to support clinicians
developing national clinical data standards, initially to support the national priority areas.
These standards are an essential element of the Electronic Health Record, a central aim of
the National e-Health Strategy. More information can be found on our website.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007            2
Generic Data Items
Data standards which are relevant to all patients and are used across specialties, disciplines
and settings have already been developed by wider Generic Data Standards clinical working
groups and approved as national data standards for NHS Scotland. The Cancer Pathology
Core Data Standards working group selected several generic data items for inclusion in their
standards. These data items names and definitions are listed in this document for
information. The detail of these existing standards are available on the web based Health and
Social Care Data Dictionary.

Clinical Terminology
The strategic standard for clinical terminology in NHS Scotland is SNOMED-Clinical Terms.
This means that clinical information systems will record clinical data using this international
standard. It is intended that the NCDDP Support Team will develop recommended SNOMED
CT specifications as part of the data standards and datasets it supports.

Date Recording
It is good record-keeping practice always to identify the date of recording of any clinical
information. It is expected that all clinical information systems should include ‘date stamping’
as standard functionality, therefore the Lung Cancer Pathology Data Standards do not deal
with this issue. In many clinical situations, the date of an event, investigation, etc. is
required for clinical purposes and should be visible to the health care professional. This
date may not be the same as the date on which the data are entered onto the system. In
these instances the system must allow the health care professional to enter whichever date
is appropriate.      These issues must be addressed during system specification and
development. The Cancer Generic Data Standards do not include standards for recording
dates, though the date format for storage and management within a system should conform
to the Government Data Standards Catalogue format: CCYY-MM-DD. However, this does
not preclude entry or display of data on the user interface using the traditional DD-MM-
CCYY format.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007              3
Published Data Standards
Generic and Previously Consulted 1
 Generic Data Items                           Definition
 Person Family Name                           That part of a person’s name which is used to describe family, clan,
                                              tribal group or marital association.
 Person Given Name                            The forename or given name of a person.
 Person Birth Date                            The date of which a person was born or is officially deemed to have
                                              been born, as recorded on the Birth Certificate.
 Person Sex at Birth                          This is a factual statement, as far as is known, about the
                                              phenotypic (biological) sex of the person at birth.
 Location Code                                This is the reference number of any building or set of buildings
                                              where events pertinent to NHS Scotland take place. Locations
                                              include hospitals, health centres, GP surgeries, clinics, NHS board
                                              offices, nursing homes, schools and patients/clients’ home.
 Health Record Identifier                     A patient Health Record Identifier is a code (set of characters) used
                                              to uniquely identify a patient within a health register or a health
                                              records system e.g. PAS.
 CHI Number                                   The Community Health Index (CHI) is a population register, which
                                              is used in Scotland for health care purposes. The CHI number
                                              uniquely identifies a person on the index.
 Associated Professional                      Associated Professionals are those individuals who are involved
     - Identifier                             with the client/ patient in a professional capacity e.g. consultant,
     - Group                                  social worker, occupational therapist etc.
     - Role
 Cancer Generic Data Items                    Definition
 Date            Histo/Cytopathological       This is the date the histo/ cytopathological specimen was taken.
 specimen taken
 Histo/Cytopathology report number            The reference number of the histo/cytopathology specimen.
 Histo/Cytopathology       investigation      The date that the result of the specimen was reported by the
 report date                                  pathology laboratory.
 Site of Origin of Primary tumour             The anatomical site of origin of the primary tumour according to the
                                              International Classification of Diseases for Oncology (ICD-O(3)).
 Tumour Type (Morphology                 of   The morphology of the tumour according to the International
 Tumour) (Cancer)                             Classification of Diseases for Oncology (ICD-O(3)).
 Most Valid Basis of Diagnosis                The best evidence in support of the diagnosis of cancer.
 Previously Treated for Cancer                A record of whether or not the patient has had treatment for the
                                              management of a previous cancer.
 Cancer Pathology Generic Data                Definition
 Items
 Maximum Macroscopic Tumour                   The macroscopic size of the tumour as measured in millimetres
 Diameter (Cancer)                            (mm).
 Maximum      Microscopic    Tumour           The microscopic size of the tumour as measured in millimetres
 Diameter (Cancer)                            (mm).
 Distance to Nearest Margin (Cancer)          An indicator of whether all the excision margins were clear of
                                              tumour i.e. that there was complete resection of the tumour at all
                                              margins.

 Distance to Deep Margin                      This denotes the distance of the tumour from the deep margin in
                                              millimetres (mm).
 Synchronous        Tumour       Indicator    A record of the presence of multiple tumours at the same time.
 (Cancer)


1 All data items in the table above are existing nationally approved data standards, which can be found in the
Health and Social care Data Dictionary.



Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007                                 4
Section 2. - Lung Cancer Pathology Data Standards

2.1 Distance from Bronchial or Medial Excision Margin (Lung
Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: The distance in millimetres of the invasive carcinoma from the bronchial or
medial resection margin.

Format: Numeric

Field length: 3

Sub-data items: Status
Code     Value
96        Not applicable
99        Not known




2.2 Extent of Atelectasis (Lung Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: The presence and extent of atelectasis /obstructive pneumonitis.

Format: Characters

Field length: 2

Codes and values:
 Code   Value                                         Explanatory Notes
 00       No significant atelectasis                  None or less than 2 categories below
 01       Involving Hilar Region but not Whole Lung   T2
 02       Involving Whole Lung                        T3
 03       Not assessable
 99       Not known                                   Includes ‘not recorded’.

Further information: Atelectasis is the collapse of part or all of a lung by blockage of the
air passages (bronchus or bronchioles), or by very shallow breathing.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007             5
2.3 Acinar Pattern Percentage (Adenocarcinoma) (Lung Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: A record of the percentage of acinar pattern present.

Format: Numeric

Field length: 3

Sub-data items: Status
Code     Value
96        Not applicable
99        Not known



2.4 Papillary Pattern Percentage (Adenocarcinoma) (Lung Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: A record of the percentage of papillary pattern present.

Format: Numeric

Field length: 3

Sub-data items: Status
Code     Value
96        Not applicable
99        Not known




2.5 Solid with Mucin Pattern Percentage (Adenocarcinoma) (Lung
Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: A record of the percentage of solid with mucin pattern present.

Format: Numeric

Field length: 3

Sub-data items: Status
Code     Value
96        Not applicable
99        Not known


Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007   6
Further information: Intracellular mucin-containing vacuoles in more than five cells in two
consecutive high power fields of an otherwise undifferentiated carcinoma.


2.6 Bronchioloalveolar Pattern Percentage (Adenocarcinoma) (Lung
Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: A record of the percentage of bronchioloalveolar pattern present.

Format: Numeric

Field length: 3

Sub-data items: Status
Code     Value
96        Not applicable
99        Not known

Further information: Tumour with a wholly lepidic growth pattern without evidence of
stromal, vascular or pleural invasion.


2.7 Central Scar (Adenocarcinoma) (Lung Cancer)
Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: An indicator of the presence of a central scar.

Format: Characters

Field length: 2

Codes and values:
Codes Value
00       No
01       Yes
99       Not known

Further information:
The presence of central scars in patients with T1 mixed pattern adenocarcinoma which have
a focal bronchioloalveolar pattern provide prognostic data.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007              7
2.8 Size of Central Scar (Adenocarcinoma) (Lung Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: A record of the size of the central scar in millimetres (mm).

Format: Characters

Field length: 2

Codes and values:
Codes Value
01       5 mm or less
02       > 5 – 10mm
03       > 10mm
96       Not applicable
99       Not known

Further information: The presence of central scars in patients with T1 mixed pattern
adenocarcinoma which have a focal bronchioloalveolar pattern provide prognostic data.


2.9 Invasion into Central Scar (Adenocarcinoma) (Lung Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: An indicator of the extent of invasion into the central scar.

Format: Characters

Field length: 3

Codes and values:
Codes Value

00       None
01       Marginal
02       Central (Extensive)
96       Not applicable
99       Not known

Further information: The presence of central scars in patients with T1 mixed pattern
adenocarcinoma which have a focal bronchioloalveolar pattern provide prognostic data.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007   8
2.10 Extent of Invasion into Central Scar (Adenocarcinoma) (Lung
Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: A record of the extent of invasion into the central scar in millimetres (mm).

Format: Numeric

Field length: 2

Sub-data items: Status
Code     Value
96        Not applicable
99        Not known

Further information: The presence of central scars in patients with T1 mixed pattern
adenocarcinoma, which have a focal bronchioloalveolar pattern provide prognostic data.

Recording guidance:
The extent of invasion is measured in millimetres (mm).




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007            9
2.11 Extent of Local Invasion (Lung Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: An indication of the presence and extent of local invasion.

Format: Characters

Field length: 3

Codes and values:
Codes Value                             Sub-       Sub-value                      Explanatory
                                        code                                      Notes
00       No
01       Visceral Pleura                Breach of superficial elastic layer of pleura.
02       Parietal Pleura / Chest Wall
03       Mediastinal Pleura
04       Pericardium
05       Diaphragm
06       Great Vessel                   A          Aorta
                                        B          Central Pulmonary Artery
                                        C          Central Pulmonary Vein
                                        D          Superior Vena Cava
                                        E          Inferior Vena Cava
07       Atrium, Heart
08       Malignant Pleural Effusion
09       Separate Tumour Nodules in
         Same Lobe
96       Not applicable
98       Other (specify)
99       Not known                      Includes ‘not recorded’.

Recording guidance:
IT systems should allow for multiple recording of this item.

Users may wish to augment code ‘98 – Other specify’ with a free text field for recording other
type of specimen.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007                10
2.12 Lymph Nodes Type Submitted (Lung Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: The anatomical groups of lymph nodes received for pathological examination
following surgery.

Format: Characters

Field length: 3

Codes and values:
Code Description                               Sub-       Sub-value        Explanatory notes
                                               code
01      Intrapulmonary Lymph Nodes          Node stations 11-14
                                            A          Not submitted
                                            B          Submitted
02      Ipsilateral Hilar Lymph Nodes       Node station 10
                                            A          Not submitted
                                            B          Submitted
03      Ipsilateral Mediastinal Lymph Nodes Node stations 1-9
                                            A          Not submitted
                                            B          Submitted
04      Contralateral Mediastinal, Hilar
        Lymph Nodes
                                               A          Not submitted
                                               B          Submitted
05      Ipsilateral or Contralateral Scalene
        or Supraclavicular Lymph Nodes
                                               A           Not submitted
                                               B           Submitted
96      Not applicable                         e.g No nodes sampled.
99      Not known                              Includes ‘not recorded’.

Attributes:
Laterality: Right, Left, Bilateral, Midline

Related data items: Lymph Node Type Involved (Lung Cancer)

Recording guidance:
Each type of lymph node selected from the list should also have the laterality recorded.

IT systems should allow for multiple recording of this item.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007           11
2.13 Lymph Nodes Type Involved (Lung Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: The anatomical groups of lymph nodes identified with metastases following
pathological examination.

Format: Characters

Field length: 3

Codes and values:
Code Description                                 Sub-       Sub-value       Explanatory notes
                                                 code
01     Intrapulmonary Lymph Nodes                Node stations 11-14
                                                 A          Not Involved
                                                 B          Involved
02     Ipsilateral Hilar Lymph Nodes             Node station 10
                                                 A          Not Involved
                                                 B          Involved
03     Ipsilateral Mediastinal Lymph Nodes       Node stations 1-9
                                                 A          Not Involved
                                                 B          Involved
04     Contralateral Mediastinal, Hilar Lymph
       Nodes
                                                 A          Not Involved
                                                 B          Involved
05     Ipsilateral or Contralateral Scalene or
       Supraclavicular Lymph Nodes
                                                 A          Not Involved
                                                 B          Involved
96     Not applicable                            e.g No nodes sampled.
99     Not known                                 Includes ‘not recorded’.

Attributes:
Laterality: Right, Left, Bilateral, Midline

Related data items: Lymph Node Type Submitted (Lung Cancer)

Recording guidance: Each type of lymph node selected from the list should also have the
laterality recorded.
IT systems should allow for multiple recording of this item.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007                12
2.14 Margins Involved (Lung Cancer)

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: An indication of the extent of marginal involvement of lung cancer.

Format: Characters

Field length: 3

Codes and values:
 Code     Value                   Sub-       Sub-value
                                  code
 00       None
 01       Bronchial Margin        A          Not Involved
                                  B          Involved
                                  C          Not assessable
                                  D          Not known
 02       Mediastinal Margin      A          Not Involved
                                  B          Involved
                                  C          Not assessable
                                  D          Not known
 03       Vascular Margin         A          Not Involved
                                  B          Involved
                                  C          Not assessable
                                  D          Not known
 04       Chest Wall Margin       A          Not Involved
                                  B          Involved
                                  C          Not assessable
                                  D          Not known
 05       Diaphragmatic margin    A          Not Involved
                                  B          Involved
                                  C          Not assessable
                                  D          Not known
 99       Not known               Includes ‘not recorded’.


Recording guidance:
Each type of lymph node selected from the list should also have the laterality recorded.

IT systems should allow for multiple recording of this item.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007           13
2.15 Emphysema

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: An indication of the presence of emphysema.

Format: Characters

Field length: 2

Codes and values:
 Code     Value            Explanatory Notes
 00       No
 01       Yes
 96       Not applicable   e.g Not sampled.
 99       Not known        Includes           ‘not
                           recorded’.


2.16 Degree of Emphysema

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: An indication of the degree of emphysema.

Format: Characters

Field length: 2

Codes and values:
 Code     Value            Explanatory Notes
 00       None
 01       Mild             May be revised by college
 02       Moderate         May be revised by college
 03       Severe           May be revised by college
 96       Not applicable   e.g Not sampled.
 99       Not known        Includes ‘not recorded’.



2.17 Diffuse Parenchymal Lung Disease

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: An indication of the presence of diffuse lung disease (other than emphysema)
and not (probably) associated with airway obstruction.

Format: Characters

Field length: 2


Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007     14
Codes and values:
 Code     Value                   Explanatory Notes
 00       Not present
 01       Present
 96       Not applicable          e.g Not sampled.
 99       Not known               Includes           ‘not
                                  recorded’.




2.18 Diffuse Parenchymal Lung Disease: Pattern of Disease Present

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007.

Definition: A record of the pattern of disease present.

Format: Characters

Field length: 2

Codes and values:
 Code     Value                                 Explanatory Notes
 00       Non-specific Interstitial Pneumonia
 01       Usual Interstitial Pneumonia
 02       Respiratory Bronchiolitis
 03       Granulomatous Disease
 96       Not applicable
 98       Other (specify)
 99       Not known                             Includes ‘not recorded’.

Related data item: Diffuse Lung Disease

Recording guidance:
This item may occur more than once throughout a patient’s record.

Users may wish to augment code ‘98 – Other specify’ with a free text field for recording other
type of specimen.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007           15
2.19 Aetiology of Diffuse Parenchymal Lung Disease

Main source of standard: The Royal College of Pathologists, Dataset for Lung Cancer
Histopathology Reports (2nd edition), Draft, January 2007 and American Lung Association,
2007.

Definition: A record of the cause of diffuse lung disease.

Format: Characters

Field length: 3

Codes and values:
 Code     Value                    Sub- Sub-value                          Explanatory Notes
                                   code
 01       Occupational/Environ     Workers such as miners exposed to asbestos or metal dusts that
          mental exposure          can damage the lungs, especially the small airways and air sacs,
                                   and cause scarring (fibrosis).

                                   Agricultural workers also can be affected by some organic
                                   substances, such as mouldy hay, and other fumes found on farms.
                                   A       Hypersensitivity Pneumonitis     e.g. Farmer’s lung
                                   B       Asbestosis
                                   C       Silicosis
                                   D       Coal Worker’s Pneumoconiosis
                                   E       Effects of tobacco smoke (other e.g.            Respiratory
                                           than emphysema)                  bronchiolitis-
                                                                            associated interstitial
                                                                            lung disease (RBILD),
                                                                            Desquamative
                                                                            interstitial lung disease
                                                                            (DIP).
                                   Z       Other (specify)
 02       Sarcoidosis
 03       Chemo/Radiotherapy       e.g. treatment for breast cancer
 04       Features suggestive
          of         underlying
          connective      tissue
          disease
 98       Other (specify)
 96       Not applicable           e.g. Not sampled.
 99       Not known                Includes ‘not recorded’.

Related data item:
Diffuse Lung Disease
Diffuse Lung Disease: Pattern of Disease Present

Further information:
Sub values are not applicable for pathological use.

Recording guidance:
Users may wish to augment code ‘98 – Other specify’ with a free text field for recording other
type of specimen.



Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007                   16
2.20 TNM Tumour Classification (Pathological) (Non-small Cell
Carcinoma of Lung)
Common name: Pathological TNM Tumour stage (Lung Cancer)

Main source of standard: TNM Classification (TNM Classification of Malignant Tumours,
Sixth Edition, UICC, 2002).

Definition: A record of the size and extent of the tumour of the lung following resection of
the primary cancer.

Format: Characters

Field length: 2

Code Value                       Explanatory Notes

00     TNM Classification pT0    No evidence of primary tumour
01     TNM Classification pTis   Carcinoma in situ (CIS)
02     TNM Classification pT1    Tumour up to ≤ 3cm, surrounded by lung or visceral pleura,
                                 without bronchoscopic evidence of invasion more proximal
                                 than the lobar bronchus (i.e. not the main bronchus).
03     TNM Classification pT2    Tumour with any of the of the following:
                                 • Tumour >3 cm
                                 • Involves main bronchus, 2cm or more distal to the carina
                                 • Invades visceral pleura
                                 • Associated with atelectasis or obstructive pneumonitis
                                     that extends to the hilar region but does not involve the
                                     entire lung.
04     TNM Classification pT3    Tumour of any size that directly invades any of the following:
                                 chest wall (including superior sulcus tumours), diaphragm,
                                 mediastinal pleura, parietal pericardium; or tumour in the
                                 main bronchus < 2cm distal to the carina1 but without
                                 involvement of the carina; or associated atelectasis or
                                 obstructive pneumonitis of the entire lung.

05     TNM Classification pT4    Tumour of any size that invades any of the following:
                                 Mediastinum, heart, great vessels, trachea, oesophagus,
                                 vertebral body, carina; separate tumour nodule(s) in the
                                 same lobe; tumour with malignant pleural effusion2.
06     TNM Classification pTX    Primary tumour cannot be assessed
99     Not known                 Includes ‘not recorded’.

Related data items: TNM Nodal Classification (Pathological) (Lung Cancer)
                    TNM Metastases Classification (Pathological) (Lung Cancer)

Further information:
1
  The uncommon superficial spreading tumour of any size with its invasive component limited
to the bronchial wall, which may extend proximal to the main bronchus, is also classified as
T1.
2
  Most pleural effusions with lung cancer are due to tumour. In a few patients, however,
multiple cytopathological examinations of pleural fluid are negative for tumour, and the fluid
is non-bloody and is not an exudates. Where these elements and clinical judgement dictate


Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007                  17
that the effusion is not related to the tumour, the effusion should be excluded as a staging
element and the patient should be classified as T1, T2 or T3.



2.21 TNM Nodal Classification (Pathological) (Non-small Cell
Carcinoma of Lung)

Common name: Pathological TNM Nodal stage (Lung Cancer)

Main source of standard: TNM Classification (TNM Classification of Malignant Tumours,
Sixth Edition, UICC, 2002)

Definition: A record of the extent of regional lymph node metastases.

Format: Characters

Field length: 2

Codes and values:
Code   Value                    Explanatory Notes
00     TNM Classification pN0 No regional lymph nodes metastasis.

01     TNM Classification pN1 Metastases in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes
                              and intrapulmonary nodes, including involvement by direct extension.
                              (Node stations 10-14).
02     TNM Classification pN2 Metastasis in ipsilateral mediastinal and/or subcarinal lymph node(s).
                              (Node stations 1-9).
03     TNM Classification pN3 Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or
                              contralateral scalene, or supraclavicular lymph node(s).
04     TNM Classification pNX Regional lymph nodes cannot be assessed (e.g. previously removed).

99     Not known                Includes ‘not recorded’.

Related Data items:
TNM Tumour Classification (Pathological) (Lung Cancer)
TNM Metastases Classification (Pathological) (Lung Cancer)
Lymph Nodes Type Submitted (Lung Cancer)
Lymph Nodes Type Involved (Lung Cancer)

Further information: Histological examination of hilar and mediastinal lymphadenectomy
specimen(s) will ordinarily include 6 or more lymph nodes. If the lymph nodes are negative
but the number ordinarily examined is not met, classify as pN0.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007                18
2.22 TNM Metastases Classification (Pathological) (Non-small Cell
Carcinoma of Lung)

Common name: Pathological TNM Metastases Classification (Lung Cancer)

Main source of standard: TNM Classification (TNM Classification of Malignant Tumours,
Sixth Edition, UICC, 2002)

Definition: A record of the extent of metastatic spread of the tumour as detected by
microscopy.

Format: Characters

Field length: 2

Codes and values:
Code Value                      Explanatory Notes
00     TNM Classification pM0   No distant metastases.
01     TNM Classification pM1   Distant metastases present, includes separate tumour nodule(s) in
                                a different lobe (ipsilateral or contralateral).
02     TNM Classification pMX Presence of distant metastases cannot be assessed.
99     Not known              Includes ‘not recorded’.


Related data items:
TNM Nodal Classification (Pathological) (Lung Cancer)
TNM Tumour Classification (Pathological) (Lung Cancer)


2.23 Grade of Differentiation (Lung Cancer)
Main source of standard: TNM Classification (TNM Classification of Malignant Tumours,
Sixth Edition, UICC, 2002)

Definition: The extent to which differentiation of immature unspecialised cells to the mature
specialized form and function has taken place.

Format: Characters

Field length: 2

Codes and values:
Code       Value             Explanatory Notes
01         Grade I           Well Differentiated, (Differentiated NOS)
02         Grade II          Moderately Differentiated, (Intermediate Differentiation), (Moderately
                             Well Differentiated).
03         Grade III         Poorly Differentiated
04         Grade IV          Undifferentiated, (Anaplastic)
05         Not
96         Not applicable
99         Not known         Includes ‘not recorded’.



Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007                 19
Attributes:
Classification:
UICC

Further information: This is a qualitative assessment of the differentiation of the tumour
expressed as the extent to which a tumour resembles the normal tissue at that site.

Recording guidance: If the description of the tumour overlaps categories e.g. poor to
moderate, record the worst mentioned grade i.e. poorly differentiated.

In specimens with a tumour comprising both invasive and non-invasive components record
the grade for the invasive part.



2.24 Pre-Invasive Lung Lesions (Lung Cancer)

Main source of standard: TNM Classification (TNM Classification of Malignant Tumours,
Sixth Edition, UICC, 2002)

Definition: An indication of the type of pre-invasive lesions present.

Format: Characters

Field length: 3

Codes and values:
Code     Value                         Sub-      Sub-value               Explanatory Notes
                                       code
00       None
01       Squamous Metaplasia
02       Squamous Dysplasia
                                         A       Mild
                                         B       Moderate
                                         C       Severe
03       Squamous carcinoma in-situ
04       Hyperplasia
                                         A       Atypical
                                                 Adenomatous
                                         B       Neuroendocrine Cell
05       Not assessable
96       Not applicable
99       Not known                       Includes ‘not recorded’.

Recording guidance: IT systems should allow for multiple recording of this item.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007             20
Section 3. - Pleural Mesothelioma Pathology Data
Standards
3.1 Source of Specimen (Pleural Mesothelioma)

Definition: The source of specimen reported.

Format: Characters

Field length: 3

Codes and values:
 Code Value                                   Sub-code   Sub-value
 00       None
 01       Pleural aspirate
 02       Biopsy
                                              A          Blind percutaneous
                                              B          Radiologically guided
                                              C          Video assisted thorascopic surgery (VATS)
                                              D          Rib Resection and Pleural biopsy
                                              Z          Other (specify) e.g. biopsies of metastatic
                                                         deposits
 03       Surgical excision                   A          Pleurectomy
                                              B          Radical pleuro-pneumonectomy
                                              Z          Other (specify)
 98       Other (specify)
 99       Not known

Attribute:
Laterality: Right, Left, Bilateral, Midline

Related data items:
Date Histo/Cytopathological Specimen Taken, Result of Specimen

Further information:
This is the sample taken to determine diagnosis.

Recording guidance:
This item may occur more than once throughout a patient’s record.
Users may wish to augment code ‘98 – Other specify’ with a free text field for recording other
type of specimen.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007               21
3.2 TNM Tumour Classification (Pathological) (Pleural
Mesothelioma)
Common name: Pathological TNM Tumour stage (Pleural Mesothelioma)

Main source of standard: TNM Classification (TNM Classification of Malignant Tumours,
Sixth Edition, UICC, 2002).

Definition: A record of the size and extent of the tumour of the lung following resection of
the primary cancer.

Format: Characters

Field length: 3

Code     Value               Sub-      Sub-       Explanatory Notes
                             code      value
00       TNM Classification No evidence of primary tumour
         pT0
01       TNM Classification Tumour involves parietal pleura, with or without focal involvement of
         pT1                visceral pleura.

                             A         pT1a       Tumour involves ipsilateral parietal (mediastinal,
                                                  diaphragmatic) pleura. No involvement of visceral
                                                  pleura.
                             B         pT1b       Tumour involves ipsilateral parietal (mediastinal,
                                                  diaphragmatic) pleura, with focal involvement of
                                                  the visceral pleura.
02       TNM Classification Tumour involves any ipsilateral pleural surfaces, with at least one of
         pT2                the following:
                            • Confluent visceral pleural tumour (including the fissure)
                            • Invasion of diaphragmatic muscle
                            • Invasion of lung parenchyma .
03       TNM Classification Tumour involves any ipsilateral pleural surfaces, with at least one of
         pT3*               the following:
                            • Invasion of endothoracic fascia
                            • Invasion into mediastinal fat
                            • Solitary focus of tumour invading soft tissues of the chest wall
                            • Non-transmural involvement of the pericardium.

04       TNM Classification Tumour involves any ipsilateral pleural surfaces, with at least one of
         pT4†               the following:
                            • Diffuse or multifocal invasion of the soft tissues of chest wall
                            • Any involvement of rib
                            • Invasion through diaphragm to peritoneum
                            • Invasion of any mediastinal organ(s)
                            • Direct extension to contralateral pleura
                            • Invasion into the spine
                            • Extension to internal surface of pericardium
                            • Pericardial effusion with positive cytology
                            • Invasion of myocardium
                            • Invasion of brachial plexus.




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007                     22
05         TNM Classification Primary tumour cannot be assessed
           pTX

99         Not known           Includes ‘not recorded’.

Related data items: TNM Nodal Classification (Pathological) (Pleural Mesothelioma)
                    TNM Metastases Classification (Pathological) (Pleural Mesothelioma)

Further information:
*
  T3 describes locally advanced but potentially resectable tumour.
†
    T4 describes locally advanced, technically unresectable tumour.



3.3 TNM Nodal Classification (Pathological) (Pleural Mesothelioma)

Common name: Pathological TNM Nodal stage (Pleural Mesothelioma)

Main source of standard: TNM Classification (TNM Classification of Malignant Tumours,
Sixth Edition, UICC, 2002)

Definition: A record of the extent of regional lymph node metastases.

Format: Characters

Field length: 2

Codes and values:
Code      Value                   Explanatory Notes

00        TNM Classification pN0 No regional lymph nodes metastasis.

01        TNM Classification pN1 Metastasis in ipsilateral bronchopulmonary and/or hilar lymph node(s).

02        TNM Classification pN2 Metastasis in subcarinal lymph node(s) and/or ipsilateral internal
                                 mammary or mediastinal lymph node(s).
03        TNM Classification pN3 Metastasis in contralateral mediastinal, internal mammary, or hilar
                                 node(s) and/or ipsilateral or contralateral supraclavicular or scalene
                                 lymph node(s).
04        TNM Classification pNX Regional lymph nodes cannot be assessed (e.g. previously removed).

99        Not known               Includes ‘not recorded’.

Related Data items: TNM Tumour Classification (Pathological) (Pleural Mesothelioma)
                    TNM Metastases Classification (Pathological) (Pleural Mesothelioma)




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007                 23
3.4 TNM Metastases                     Classification          (Pathological)         (Pleural
Mesothelioma)

Common name: Pathological TNM Metastases Classification (Pleural Mesothelioma)

Main source of standard: TNM Classification (TNM Classification of Malignant Tumours,
Sixth Edition, UICC, 2002)

Definition: A record of the extent of metastatic spread of the tumour as detected by
microscopy.

Format: Characters

Field length: 2

Codes and values:
Code Value                             Explanatory Notes
00     TNM Classification pM0          No distant metastases.
01     TNM Classification pM1          Distant metastases present.
02     TNM Classification pMX          Presence of distant metastases cannot be assessed.
99     Not known                       Includes ‘not recorded’.


Related data items: TNM Nodal Classification (Pathological) (Pleural Mesothelioma);
                    TNM Tumour Classification (Pathological) (Pleural Mesothelioma)



3.5 Histological Diagnosis (Pleural Mesothelioma)

Definition: A record of the diagnosis as assessed by the pathologist.

Format: Characters

Field length: 3

Codes and values:
Codes Value                                             Sub-     Sub-value
                                                        code
01       Normal
02       Suspicious (but not diagnostic of
         mesothelioma)
03       Mesothelioma                                   A        Epitheliod
                                                        B        Mixed Epitheloid and Sarcomatoid
                                                        C        Sarcomatoid
99       Not known




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007             24
Appendix 1 - Working Group Membership
Membership of Cancer Pathology Core Data Standards Clinical Working Group

Alistair Robertson (Chair)   EHealth Lead for Cancer
                             Scottish Cancer Group
David Brewster               Director
                             Cancer Registration in Scotland
Prof. Frank Carey            Clinical Lead, Scottish Pathology Network (SPAN)
                             SPAN/NHS Tayside
Derek Bishop                 Scottish Pathology Network Manager
                             NHS Tayside
Mark Ashton                  Consultant Pathologist
                             NHS Highland
E Robert Nairn               Consultant Pathologist
                             NHS Ayrshire and Arran
Jon Coldewey                 Consultant Pathologist
                             NHS Lanarkshire
Jeremy Thomas                Consultant Pathologist
                             NHS Lothian
Keith Kerr                   Consultant Pathologist, Professor of Pulmonary
                             Pathology
                             NHS Grampian
William Wallace              Consultant Pathologist
                             NHS Lothian
Margaret Balsitis            Consultant Pathologist
                             NHS Ayrshire and Arran
Jean Harvey (Developer)      Cancer Data Definitions Manager
                             NCDDP, Information Services, NSS
Kathy Clarke                 Cancer Information Co-ordinator
                             NCDDP, Information Services, NSS
Kjersti Fergusson            Information Manager
                             NCDDP, Information Services, NSS




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007   25
Appendix 2 Consultation Distribution List
•    Association of Upper Gastrointestinal Surgeons (AUGIS)
•    Association of Colproctology
•   British Association of Surgical Oncologist (BASO)
•   British Association of Urological Surgeons (BAUS)
•   British Medical Association
•   Cancer Backup
•   Cancer eHealth Data & IT subgroup
•   Cancer Genetics Leads
•   Chartered Society of Physiotherapists
•   Clinical Effectiveness Support Group (Wales)
•   Clinical Health Psychology (Scotland)
•   College of Occupational Therapists
•   Community Nurses Network
•   Craig White
•   Data for Head and Neck Oncology (DAHNO)
•   ECase Developer
•   English Cancer Registry
•   Faculty of Clinical Health Psychology (Scotland)
•   Head of Theraputic Radiology
•   Health & Social Care Dataset Development Programme London
•   Health & Social Care Information Centre, Datasets Development Programme (England)
•   Health Professions Council
•   Health Protection Scotland
•   Information Services (ISD)
•   Information Standards Group
•   MacMillan Cancer Relief
•   Mike Cornbleet (SE Lead for radiotherapy planning)
•   Miscellaneous
•   National Clinical Audit Support Programme (NCASP)
•   National Clinical Dataset Development Programme Board
•   National Prospective Cancer Audit Working Group (NPCAWG)
•   National Services Division
•   National Waiting Times Unit
•   NHS Board Chief Executives
•   NHS Board Directors of Public Health
•   NHS Health Scotland
•   NHS Health Education Scotland
•   NHS Quality Improvement Scotland
•   NHS24
•   Regional Cancer Lead Clinicians
•   Regional Cancer Networks (SCAN, NOSCAN, WOSCAN)
•   Regional Cancer Networks Audit Leads
•   Regional Cancer Networks Lead clinicians
•   Royal College of General Practitioners (Scotland)
•   Royal College of Nursing (Scotland)
•   Royal College of Pathologists
•   Royal College of Physicians
•   Royal College of Physicians and Surgeons Glasgow
•   Royal College of Physicians London

Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007    26
•   Royal College of Radiologists
•   Royal College of Surgeons
•   Scottish Cancer Group
•   Scottish Cancer Pharmacy Group
•   Scottish Cancer Registry
•   Scottish Cancer Research Networks
•   Scottish Clinical Information Management Practice (SCIMP)
•   Scottish eHealth Nursing Forum
•   Scottish Executive Centre for Change and Innovation
•   Scottish Executive Health Improvement Department
•   Scottish Intercollegiate Guidelines Network
•   Scottish Partnership for Palliative Care
•   Scottish Pathology Network
•   UK Data Standards Forum
•   UK Regional cancer registry directors
•   WOSCAN MCN Managers

NCDDP Reference & Working Groups

•   NCDDP Board
•   NCDDP Support Team
•   Cancer Pathology Core Data Standards
•   Endometrial Cancer Pathology Data Standards
•   Head & Neck Cancer Pathology Data Standards
•   Gynaecological Cancer Pathology Data Standards




Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007   27
Appendix 3 – Consultation Response (Lung Cancer
Pathology)
We value your opinion. These data standards have been developed to support the work of
clinicians. Therefore, we need your input.
We welcome suggestions for amendments, improvements and feedback on any issues.
Below are some of the key things we would like you to consider when reviewing the data
standards:
• The definitions of data items – are they clear and fit for purpose?
• The format of data items (e.g. free text or pick list, field length)
• The content of code sets – any codes that are superfluous or missing?

A number of the standards detailed are included for more than one cancer grouping and for
anyone reviewing more than one set of standards it should be noted these are in bold on the
response forms and comments on recurring items should only be completed on one form

All comments are welcome, whether they are on all or part of the data standards.

                  Closing date for responses is Friday 26th October 2007
Name:

Title/Designation:

Organisation:

Telephone No:

E-mail (Required):
(This is essential so that we can follow up on/ reply to any comments you have made).



          Data Item                                   Consultation feedback
                               Have you     Details of any suggested alterations, additions or
                               reviewed     clarifications
                               this data
                               item?
                               (Y/N)
2. Lung Cancer Pathology
2.1 Distance from Bronchial
or Medial Excision Margin
(Lung Cancer)
2.2 Extent of Atelectasis
(Lung Cancer)
2.3 Acinar Pattern
Percentage
(Adenocarcinoma) (Lung
Cancer)
2.4 Papillary Pattern
Percentage
(Adenocarcinoma) (Lung
Cancer)



Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007                 28
2.5 Solid with Mucin Pattern
Percentage
(Adenocarcinoma) (Lung
Cancer)
2.6 Bronchioloalveolar
Pattern Percentage
(Adenocarcinoma) (Lung
Cancer)
2.7 Central Scar
(Adenocarcinoma) (Lung
Cancer)
2.8 Size of Central Scar
(Adenocarcinoma) (Lung
Cancer)
2.9 Invasion into Central
Scar (Adenocarcinoma)
(Lung Cancer)
2.10 Extent of Invasion into
Central Scar
(Adenocarcinoma) (Lung
Cancer)
2.11 Extent of Local Invasion
(Lung Cancer)
2.12 Lymph Nodes Type
Submitted (Lung Cancer)
2.13 Lymph Nodes Type
Involved (Lung Cancer)
2.14 Margins Involved (Lung
Cancer)
2.15 Emphysema
2.16 Degree of Emphysema
2.17 Diffuse Parenchymal
Lung Disease
2.18 Diffuse Parenchymal
Lung Disease: Pattern of
Disease Present
2.19 Aetiology of Diffuse
Parenchymal Lung Disease
2.20 TNM Tumour
Classification (Pathological)
(Non-small Cell Carcinoma
of Lung)
2.21 TNM Nodal
Classification (Pathological)
(Non-small Cell Carcinoma
of Lung)
2.22 TNM Metastases
Classification (Pathological)
(Non-small Cell Carcinoma
of Lung)
2.23 Grade of Differentiation
(Lung Cancer)



Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007   29
2.24 Pre-Invasive Lung
Lesions (Lung Cancer)
3. Pleural Mesothelioma
3.1 Source of Specimen
(Pleural Mesothelioma)
3.2 TNM Tumour
Classification (Pathological)
(Pleural Mesothelioma)
3.3 TNM Nodal Classification
(Pathological) (Pleural
Mesothelioma)
3.4 TNM Metastases
Classification (Pathological)
(Pleural Mesothelioma)
3.5 Histological Diagnosis
(Pleural Mesothelioma)

Any additional views, comments or suggestions (especially on data items that might be
missing):




Please e-mail to                NCDDPsupportteam@isd.csa.scot.nhs.uk

OR Post hard copies to          NCDDP Support Team
                                Information Services
                                Area 74A Gyle Square
                                1 South Gyle Crescent
                                Edinburgh
                                EH12 9EB

                   Closing date for responses is Friday 26th October 2007

     THANK YOU FOR YOUR VALUABLE CONTRIBUTION



Lung Cancer Pathology Data Standards V1.0 for Consultation Only – September 2007   30

								
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