TNM codes being withdrawn from SNOMED CT

Clinical
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From another list

As a result of a licensing issue between AJCC and SNOMED International, all TNM cancer staging codes will shortly be removed from the next version of the International Edition of SNOMED and, therefore, will in time also be removed from the version of SNOMED that is distributed within the UK.

The TNM cancer staging system has always been the intellectual property of AJCC/UICC and is now on version 9. About 20 years ago, AJCC permitted SNOMED to add around 1000 codes relating to the capture of AJCC/UICC TNM cancer staging data as per version 6 of their staging manual. These codes have not been updated since to newer versions of the AJCC product, and so they are now significantly out of date.

To the best of NHS Digital’s knowledge, only VERY small volumes of these codes are being added today as new EPR items within the UK’s Primary or Secondary care settings, or already exist as historically captured EPR data. Further, we believe that no UK cancer registry either receives or processes cancer staging data in SNOMED Coded form. For these reasons, this code withdrawal is not expected to have any significant impact on the NHS, UK cancer care or UK cancer research.

I’m glad we decided not to try to recreate all of the specific TNM scores!!

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Where can I find more information about this?

We are currently implementing solutions for Kidney and Prostate cancer. TNM classification is a key part of this. I have done some investigations on how to use SNOMED-CT codes with openEHR archetypes here: TNM · bjornna/modelling-mdt Wiki · GitHub

Seems like we must withdraw the usage of SNOMED-CT in the solutions based on the information above.

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I can’t recall exactly where or who reported the removal of the TNM codes but I found this -

Perhaps @mikael has further information?

and possibly some pointers to what is planned next by AJCC

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I am not familiar with this, but might it be related to item 13 on the page 2022 Early Visibility Release Notifications - SNOMED International Release Management - SNOMED Confluence? Otherwise, you can send an e-mail to info@snomed.org and ask and you will probably get a good answer.

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I found the following information. It is late September 2022. Cancer Staging (AJCC TNM) | Interoperability Standards Advisory (ISA). Fyi, the current release of SNOMED CT does contain the concept identifiers for the TNM classification as subtypes of the concept “399631002 |Tumor-node-metastasis (TNM) tumor observable (observable entity)|”. The subtypes of “1222584008 |American Joint Committee on Cancer allowable value (qualifier value)|” are also available. Hope this helps.

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