This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v3.0.0: STU 3) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

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Resource Profile: Cancer Stage Profile ( Abstract )

Parent profile for observations regarding cancer stage, grade, classification, or risk group. The stage is an assessment of the extent of the cancer in the body, according to a given cancer staging classification system. Profiles for different staging systems (e.g., TNM stage group, Rai stage, FIGO stage, etc.) must derive from this profile.

Despite its name, the CancerStage profile can also be used as a parent for cancer grade, classification, and risk grouping. This is because the structure of the profiles are the same or very similar. The key elements are the code, method, value, and optionally, prognostic factors referenced in the hasMember element.

Usage:

• Derived from this Resource Profile: CLL Binet Stage Profile, CLL Rai Stage Profile, Gynecologic Tumor FIGO Stage Profile, Lymphoma Stage Profile... Show 6 more, Melanoma Breslow Depth Stage Profile, Melanoma Clark Level Profile, Myeloma ISS Stage Profile, Myeloma RISS Stage Profile, Prostate Gleason Grade Group Profile and TNM Stage Group Profile
• Refer to this Resource Profile: Primary Cancer Condition Profile

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	This is an abstract profile. Child profiles: CLLBinetStage, CLLRaiStage, GynecologicTumorFIGOStage, LymphomaStage, MelanomaBreslowDepthStage, MelanomaClarkLevel, MyelomaISSStage, MyelomaRISSStage, ProstateGleasonGradeGroup, TNMStageGroup Measurements and simple assertions
status	S	1..1	code	registered | preliminary | final | amended +
code	S	1..1	CodeableConcept	The type of stage information reported. Binding: Cancer Stage Type Value Set (preferred)
subject	S	0..1	Reference(Cancer Patient Profile)	Who and/or what the observation is about
focus	S	0..*	Reference(Primary Cancer Condition Profile)	The cancer condition associated with staging assessment.
effective[x]	S	0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation
value[x]	S	0..1	CodeableConcept	The value of the stage Binding: Cancer Stage Value Set (example)
method	S	0..1	CodeableConcept	The staging system used. Binding: Cancer Staging Method Value Set (extensible)
device		0..1	Reference(Device | DeviceMetric)	Not used in this profile
referenceRange		0..*	BackboneElement	Not used in this profile
hasMember		0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Prognostic factors contributing to stage determination.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.code	preferred	CancerStageTypeVS
Observation.value[x]	example	CancerStageValueVS
Observation.method	extensible	CancerStagingMethodVS

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	This is an abstract profile. Child profiles: CLLBinetStage, CLLRaiStage, GynecologicTumorFIGOStage, LymphomaStage, MelanomaBreslowDepthStage, MelanomaClarkLevel, MyelomaISSStage, MyelomaRISSStage, ProstateGleasonGradeGroup, TNMStageGroup Measurements and simple assertions
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	SΣ	1..1	CodeableConcept	The type of stage information reported. Binding: Cancer Stage Type Value Set (preferred)
subject	SΣ	0..1	Reference(Cancer Patient Profile)	Who and/or what the observation is about
focus	SΣ	0..*	Reference(Primary Cancer Condition Profile)	The cancer condition associated with staging assessment.
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
value[x]	SΣC	0..1	CodeableConcept	The value of the stage Binding: Cancer Stage Value Set (example)
method	S	0..1	CodeableConcept	The staging system used. Binding: Cancer Staging Method Value Set (extensible)
device		0..1	Reference(Device | DeviceMetric)	Not used in this profile
referenceRange	C	0..*	BackboneElement	Not used in this profile
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Prognostic factors contributing to stage determination.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.status	required	ObservationStatus
Observation.code	preferred	CancerStageTypeVS
Observation.value[x]	example	CancerStageValueVS
Observation.method	extensible	CancerStagingMethodVS

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	This is an abstract profile. Child profiles: CLLBinetStage, CLLRaiStage, GynecologicTumorFIGOStage, LymphomaStage, MelanomaBreslowDepthStage, MelanomaClarkLevel, MyelomaISSStage, MyelomaRISSStage, ProstateGleasonGradeGroup, TNMStageGroup Measurements and simple assertions
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	The type of stage information reported. Binding: Cancer Stage Type Value Set (preferred)
subject	SΣ	0..1	Reference(Cancer Patient Profile)	Who and/or what the observation is about
focus	SΣ	0..*	Reference(Primary Cancer Condition Profile)	The cancer condition associated with staging assessment.
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1	CodeableConcept	The value of the stage Binding: Cancer Stage Value Set (example)
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method	S	0..1	CodeableConcept	The staging system used. Binding: Cancer Staging Method Value Set (extensible)
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	Not used in this profile
referenceRange	C	0..*	BackboneElement	Not used in this profile
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Prognostic factors contributing to stage determination.
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.code	preferred	CancerStageTypeVS
Observation.value[x]	example	CancerStageValueVS
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	extensible	CancerStagingMethodVS
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

This structure is derived from Observation

Summary

Must-Support: 7 elements

Structures

This structure refers to these other structures:

• Cancer Patient Profile (http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient)
• Primary Cancer Condition Profile (http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-primary-cancer-condition)

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	Observation	This is an abstract profile. Child profiles: CLLBinetStage, CLLRaiStage, GynecologicTumorFIGOStage, LymphomaStage, MelanomaBreslowDepthStage, MelanomaClarkLevel, MyelomaISSStage, MyelomaRISSStage, ProstateGleasonGradeGroup, TNMStageGroup Measurements and simple assertions
status	S	1..1	code	registered | preliminary | final | amended +
code	S	1..1	CodeableConcept	The type of stage information reported. Binding: Cancer Stage Type Value Set (preferred)
subject	S	0..1	Reference(Cancer Patient Profile)	Who and/or what the observation is about
focus	S	0..*	Reference(Primary Cancer Condition Profile)	The cancer condition associated with staging assessment.
effective[x]	S	0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation
value[x]	S	0..1	CodeableConcept	The value of the stage Binding: Cancer Stage Value Set (example)
method	S	0..1	CodeableConcept	The staging system used. Binding: Cancer Staging Method Value Set (extensible)
device		0..1	Reference(Device | DeviceMetric)	Not used in this profile
referenceRange		0..*	BackboneElement	Not used in this profile
hasMember		0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Prognostic factors contributing to stage determination.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Observation.code	preferred	CancerStageTypeVS
Observation.value[x]	example	CancerStageValueVS
Observation.method	extensible	CancerStagingMethodVS

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	This is an abstract profile. Child profiles: CLLBinetStage, CLLRaiStage, GynecologicTumorFIGOStage, LymphomaStage, MelanomaBreslowDepthStage, MelanomaClarkLevel, MyelomaISSStage, MyelomaRISSStage, ProstateGleasonGradeGroup, TNMStageGroup Measurements and simple assertions
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	SΣ	1..1	CodeableConcept	The type of stage information reported. Binding: Cancer Stage Type Value Set (preferred)
subject	SΣ	0..1	Reference(Cancer Patient Profile)	Who and/or what the observation is about
focus	SΣ	0..*	Reference(Primary Cancer Condition Profile)	The cancer condition associated with staging assessment.
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
value[x]	SΣC	0..1	CodeableConcept	The value of the stage Binding: Cancer Stage Value Set (example)
method	S	0..1	CodeableConcept	The staging system used. Binding: Cancer Staging Method Value Set (extensible)
device		0..1	Reference(Device | DeviceMetric)	Not used in this profile
referenceRange	C	0..*	BackboneElement	Not used in this profile
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Prognostic factors contributing to stage determination.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.status	required	ObservationStatus
Observation.code	preferred	CancerStageTypeVS
Observation.value[x]	example	CancerStageValueVS
Observation.method	extensible	CancerStagingMethodVS

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	This is an abstract profile. Child profiles: CLLBinetStage, CLLRaiStage, GynecologicTumorFIGOStage, LymphomaStage, MelanomaBreslowDepthStage, MelanomaClarkLevel, MyelomaISSStage, MyelomaRISSStage, ProstateGleasonGradeGroup, TNMStageGroup Measurements and simple assertions
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	The type of stage information reported. Binding: Cancer Stage Type Value Set (preferred)
subject	SΣ	0..1	Reference(Cancer Patient Profile)	Who and/or what the observation is about
focus	SΣ	0..*	Reference(Primary Cancer Condition Profile)	The cancer condition associated with staging assessment.
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]	SΣC	0..1	CodeableConcept	The value of the stage Binding: Cancer Stage Value Set (example)
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method	S	0..1	CodeableConcept	The staging system used. Binding: Cancer Staging Method Value Set (extensible)
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	Not used in this profile
referenceRange	C	0..*	BackboneElement	Not used in this profile
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Prognostic factors contributing to stage determination.
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus
Observation.category	preferred	ObservationCategoryCodes
Observation.code	preferred	CancerStageTypeVS
Observation.value[x]	example	CancerStageValueVS
Observation.dataAbsentReason	extensible	DataAbsentReason
Observation.interpretation	extensible	ObservationInterpretationCodes
Observation.bodySite	example	SNOMEDCTBodyStructures
Observation.method	extensible	CancerStagingMethodVS
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes
Observation.component.code	example	LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason	extensible	DataAbsentReason
Observation.component.interpretation	extensible	ObservationInterpretationCodes

This structure is derived from Observation

Summary

Must-Support: 7 elements

Structures

This structure refers to these other structures:

• Cancer Patient Profile (http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient)
• Primary Cancer Condition Profile (http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-primary-cancer-condition)

Other representations of profile: CSV, Excel, Schematron