{ "resourceType" : "StructureDefinition", "id" : "bcr-cancer-registration-form", "text" : { "status" : "extensions", "div" : "

Generated Narrative: StructureDefinition bcr-cancer-registration-form

\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
NameFlagsCard.TypeDescription & Constraints\"doco\"
\".\"\".\" bcr-cancer-registration-form 0..*BaseBCR Cancer Registration Form — Bijlage 55 (Logical Model)
\".\"\".\"\".\" patientName 1..1stringPatient name
\".\"\".\"\".\" birthDate 1..1dateDate of birth
\".\"\".\"\".\" nationalOrInsuranceNumber 1..1stringINSZ / Ziekenfondsnummer
\".\"\".\"\".\" sex 1..1codeSex
Binding: BCR Sex at Birth (required)
\".\"\".\"\".\" incidenceDate 1..1dateIncidence date
\".\"\".\"\".\" basisOfDiagnosis 1..1codeBasis for diagnosis
Binding: BCR Basis of Diagnosis (required)
\".\"\".\"\".\" whoPerformanceScore 0..1codeWHO performance score at diagnosis
Binding: BCR WHO Performance Score (required)
\".\"\".\"\".\" primaryTumourLocation 1..1codePrimary tumour localisation
Binding: BCR ICD-O-3 Topography (extensible)
\".\"\".\"\".\" laterality 0..1codeLaterality
Binding: BCR Laterality (required)
\".\"\".\"\".\" histologyMorphology 1..1codeHistology — morphology
Binding: BCR ICD-O-3 Morphology (extensible)
\".\"\".\"\".\" histologyBehaviour 1..1codeHistology — behaviour
Binding: BCR ICD-O-3 Behaviour (digit only) (required)
\".\"\".\"\".\" differentiationGrade 0..1codeDifferentiation grade
Binding: BCR Differentiation Grade (required)
\".\"\".\"\".\" clinicalT 0..1stringClinical T (cT)
\".\"\".\"\".\" clinicalN 0..1stringClinical N (cN)
\".\"\".\"\".\" clinicalM 0..1stringClinical M (cM)
\".\"\".\"\".\" pathologicalT 0..1stringPathological T (pT)
\".\"\".\"\".\" pathologicalN 0..1stringPathological N (pN)
\".\"\".\"\".\" pathologicalM 0..1stringPathological M (pM)
\".\"\".\"\".\" postNeoadjuvantT 0..1stringPost-neoadjuvant pathological T (ypT)
\".\"\".\"\".\" postNeoadjuvantN 0..1stringPost-neoadjuvant pathological N (ypN)
\".\"\".\"\".\" postNeoadjuvantM 0..1stringPost-neoadjuvant pathological M (ypM)
\".\"\".\"\".\" otherClassification 0..1codeOther classification
Binding: BCR Other Stage Classification (required)
\".\"\".\"\".\" otherStageGroup 0..1stringOther classification — stage
\".\"\".\"\".\" clinicalTrialParticipation 0..1codeClinical trial participation
Binding: BCR Clinical Trial Indicator (required)
\".\"\".\"\".\" eudraCtNumber 0..1stringEudraCT number
\".\"\".\"\".\" treatmentEpisode 0..*BackboneElementTreatment chronology row
\".\"\".\"\".\"\".\" code 1..1codeDiagnosis / treatment code
Binding: BCR Treatment Chronology Code (required)
\".\"\".\"\".\"\".\" campusId 0..1stringCampus / vestigingsnummer
\".\"\".\"\".\"\".\" startDate 1..1dateStart date
\".\"\".\"\".\"\".\" endDate 0..1dateEnd date
\".\"\".\"\".\"\".\" comment 0..1stringComment
\".\"\".\"\".\" mocReport 0..*AttachmentAttached MOC report(s)

\"doco\" Documentation for this format
" }, "url" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/StructureDefinition/bcr-cancer-registration-form", "version" : "0.1.0", "name" : "BCRCancerRegistrationForm", "title" : "BCR Cancer Registration Form — Bijlage 55 (Logical Model)", "status" : "draft", "experimental" : true, "date" : "2026-05-04T06:30:16+00:00", "publisher" : "eHealth Platform Belgium", "contact" : [{ "name" : "eHealth Platform Belgium", "telecom" : [{ "system" : "url", "value" : "https://www.ehealth.fgov.be" }, { "system" : "email", "value" : "info@ehealth.fgov.be" }] }], "description" : "Logical model of the Belgian standard cancer registration form\n(*Kankerregistratieformulier voor een nieuwe diagnose*).\nThis is what hospitals submit to the Belgian Cancer Registry through WBCR\nor via batch extraction for every new cancer diagnosis.\n\nDistinct from `BCRCancerCase`, which models the *published research dataset*\nderived from these submissions plus registry follow-up.\n\nSource (canonical): Bijlage 55 to the RIZIV Verordening of 28 July 2003,\nas amended by the Verordening of 15 December 2025 (Belgisch Staatsblad\n23-12-2025, p. 96356).", "jurisdiction" : [{ "coding" : [{ "system" : "urn:iso:std:iso:3166", "code" : "BE", "display" : "Belgium" }] }], "fhirVersion" : "4.0.1", "kind" : "logical", "abstract" : false, "type" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/StructureDefinition/bcr-cancer-registration-form", "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Base", "derivation" : "specialization", "snapshot" : { "extension" : [{ "url" : "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version", "valueString" : "4.0.1" }], "element" : [{ "id" : "bcr-cancer-registration-form", "path" : "bcr-cancer-registration-form", "short" : "BCR Cancer Registration Form — Bijlage 55 (Logical Model)", "definition" : "Logical model of the Belgian standard cancer registration form\n(*Kankerregistratieformulier voor een nieuwe diagnose*).\nThis is what hospitals submit to the Belgian Cancer Registry through WBCR\nor via batch extraction for every new cancer diagnosis.\n\nDistinct from `BCRCancerCase`, which models the *published research dataset*\nderived from these submissions plus registry follow-up.\n\nSource (canonical): Bijlage 55 to the RIZIV Verordening of 28 July 2003,\nas amended by the Verordening of 15 December 2025 (Belgisch Staatsblad\n23-12-2025, p. 96356).", "min" : 0, "max" : "*", "base" : { "path" : "Base", "min" : 0, "max" : "*" }, "isModifier" : false }, { "id" : "bcr-cancer-registration-form.patientName", "path" : "bcr-cancer-registration-form.patientName", "short" : "Patient name", "definition" : "Free-text patient name as entered on the form.", "min" : 1, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.patientName", "min" : 1, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.birthDate", "path" : "bcr-cancer-registration-form.birthDate", "short" : "Date of birth", "definition" : "Patient date of birth.", "min" : 1, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.birthDate", "min" : 1, "max" : "1" }, "type" : [{ "code" : "date" }] }, { "id" : "bcr-cancer-registration-form.nationalOrInsuranceNumber", "path" : "bcr-cancer-registration-form.nationalOrInsuranceNumber", "short" : "INSZ / Ziekenfondsnummer", "definition" : "Belgian national number (INSZ/NISS) or, when unavailable, the insurance fund number.", "min" : 1, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.nationalOrInsuranceNumber", "min" : 1, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.sex", "path" : "bcr-cancer-registration-form.sex", "short" : "Sex", "definition" : "Sex of the patient.", "min" : 1, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.sex", "min" : 1, "max" : "1" }, "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-sex-at-birth-vs" } }, { "id" : "bcr-cancer-registration-form.incidenceDate", "path" : "bcr-cancer-registration-form.incidenceDate", "short" : "Incidence date", "definition" : "Date of incidence (DD-MM-YYYY) per ENCR/IACR international guidelines.", "min" : 1, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.incidenceDate", "min" : 1, "max" : "1" }, "type" : [{ "code" : "date" }] }, { "id" : "bcr-cancer-registration-form.basisOfDiagnosis", "path" : "bcr-cancer-registration-form.basisOfDiagnosis", "short" : "Basis for diagnosis", "definition" : "Most reliable method by which the diagnosis was established. Codes:\n2 = histology of primary tumour, 3 = histology of metastasis,\n4 = cytology / haematology, 5 = technical investigation (RX, endoscopy, …),\n6 = clinical, 7 = tumour marker (PSA, hCG, AFP, Ig, …),\n8 = cytogenetic / molecular tests, 9 = unknown.", "min" : 1, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.basisOfDiagnosis", "min" : 1, "max" : "1" }, "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-basis-of-diagnosis-vs" } }, { "id" : "bcr-cancer-registration-form.whoPerformanceScore", "path" : "bcr-cancer-registration-form.whoPerformanceScore", "short" : "WHO performance score at diagnosis", "definition" : "Score at incidence date. Codes:\n0 = asymptomatic, normal activity; 1 = symptomatic but ambulatory;\n2 = symptomatic, bedridden <50% per day; 3 = symptomatic, bedridden >50% per day;\n4 = fully dependent, 100% bedridden.", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.whoPerformanceScore", "min" : 0, "max" : "1" }, "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-who-performance-score-vs" } }, { "id" : "bcr-cancer-registration-form.primaryTumourLocation", "path" : "bcr-cancer-registration-form.primaryTumourLocation", "short" : "Primary tumour localisation", "definition" : "ICD-O-3 topography of the primary tumour.", "min" : 1, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.primaryTumourLocation", "min" : 1, "max" : "1" }, "type" : [{ "code" : "code" }], "binding" : { "strength" : "extensible", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-topography-vs" } }, { "id" : "bcr-cancer-registration-form.laterality", "path" : "bcr-cancer-registration-form.laterality", "short" : "Laterality", "definition" : "Laterality of the primary tumour. Codes: 1 = left, 2 = right, 3 = unpaired organ, NK = unknown.", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.laterality", "min" : 0, "max" : "1" }, "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-laterality-vs" } }, { "id" : "bcr-cancer-registration-form.histologyMorphology", "path" : "bcr-cancer-registration-form.histologyMorphology", "short" : "Histology — morphology", "definition" : "ICD-O-3 morphology code (the part before the slash on the form).", "min" : 1, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.histologyMorphology", "min" : 1, "max" : "1" }, "type" : [{ "code" : "code" }], "binding" : { "strength" : "extensible", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-morphology-vs" } }, { "id" : "bcr-cancer-registration-form.histologyBehaviour", "path" : "bcr-cancer-registration-form.histologyBehaviour", "short" : "Histology — behaviour", "definition" : "ICD-O-3 behaviour code (the part after the slash on the form: benign / borderline / in situ / malignant primary / malignant metastatic / unknown).", "min" : 1, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.histologyBehaviour", "min" : 1, "max" : "1" }, "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-behaviour-vs" } }, { "id" : "bcr-cancer-registration-form.differentiationGrade", "path" : "bcr-cancer-registration-form.differentiationGrade", "short" : "Differentiation grade", "definition" : "Grade of differentiation. Codes:\n1 = well, 2 = moderate, 3 = poor, 4 = undifferentiated / anaplastic,\n5 = T-cell, 6 = B-cell, 7 = null-cell (not T / not B),\n8 = NK cell, 9 = unknown.", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.differentiationGrade", "min" : 0, "max" : "1" }, "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-differentiation-grade-vs" } }, { "id" : "bcr-cancer-registration-form.clinicalT", "path" : "bcr-cancer-registration-form.clinicalT", "short" : "Clinical T (cT)", "definition" : "Clinical T category (UICC TNM).", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.clinicalT", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.clinicalN", "path" : "bcr-cancer-registration-form.clinicalN", "short" : "Clinical N (cN)", "definition" : "Clinical N category (UICC TNM).", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.clinicalN", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.clinicalM", "path" : "bcr-cancer-registration-form.clinicalM", "short" : "Clinical M (cM)", "definition" : "Clinical M category (UICC TNM).", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.clinicalM", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.pathologicalT", "path" : "bcr-cancer-registration-form.pathologicalT", "short" : "Pathological T (pT)", "definition" : "Pathological T category (UICC TNM).", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.pathologicalT", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.pathologicalN", "path" : "bcr-cancer-registration-form.pathologicalN", "short" : "Pathological N (pN)", "definition" : "Pathological N category (UICC TNM).", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.pathologicalN", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.pathologicalM", "path" : "bcr-cancer-registration-form.pathologicalM", "short" : "Pathological M (pM)", "definition" : "Pathological M category (UICC TNM).", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.pathologicalM", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.postNeoadjuvantT", "path" : "bcr-cancer-registration-form.postNeoadjuvantT", "short" : "Post-neoadjuvant pathological T (ypT)", "definition" : "Pathological T after neoadjuvant therapy.", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.postNeoadjuvantT", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.postNeoadjuvantN", "path" : "bcr-cancer-registration-form.postNeoadjuvantN", "short" : "Post-neoadjuvant pathological N (ypN)", "definition" : "Pathological N after neoadjuvant therapy.", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.postNeoadjuvantN", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.postNeoadjuvantM", "path" : "bcr-cancer-registration-form.postNeoadjuvantM", "short" : "Post-neoadjuvant pathological M (ypM)", "definition" : "Pathological M after neoadjuvant therapy.", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.postNeoadjuvantM", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.otherClassification", "path" : "bcr-cancer-registration-form.otherClassification", "short" : "Other classification", "definition" : "Alternative staging classification used when applicable. Codes:\n1 = Childhood Cancer Stage, 2 = FIGO, 3 = Lugano,\n4 = Breslow (in mm), 5 = other.", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.otherClassification", "min" : 0, "max" : "1" }, "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-other-classification-vs" } }, { "id" : "bcr-cancer-registration-form.otherStageGroup", "path" : "bcr-cancer-registration-form.otherStageGroup", "short" : "Other classification — stage", "definition" : "Stage value within the chosen alternative classification (e.g. Breslow depth in mm, FIGO stage).", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.otherStageGroup", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.clinicalTrialParticipation", "path" : "bcr-cancer-registration-form.clinicalTrialParticipation", "short" : "Clinical trial participation", "definition" : "Whether the cancer treatment is part of a clinical study (Ja / Nee / Onbekend).", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.clinicalTrialParticipation", "min" : 0, "max" : "1" }, "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-clinical-trial-indicator-vs" } }, { "id" : "bcr-cancer-registration-form.eudraCtNumber", "path" : "bcr-cancer-registration-form.eudraCtNumber", "short" : "EudraCT number", "definition" : "EudraCT identifier of the trial when clinical trial participation is *Ja*.", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.eudraCtNumber", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode", "path" : "bcr-cancer-registration-form.treatmentEpisode", "short" : "Treatment chronology row", "definition" : "One row of the chronology table, filled in chronologically from incidence date and first treatment.", "min" : 0, "max" : "*", "base" : { "path" : "bcr-cancer-registration-form.treatmentEpisode", "min" : 0, "max" : "*" }, "type" : [{ "code" : "BackboneElement" }], "constraint" : [{ "key" : "ele-1", "severity" : "error", "human" : "All FHIR elements must have a @value or children", "expression" : "hasValue() or (children().count() > id.count())", "xpath" : "@value|f:*|h:div", "source" : "http://hl7.org/fhir/StructureDefinition/Element" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.id", "path" : "bcr-cancer-registration-form.treatmentEpisode.id", "representation" : ["xmlAttr"], "short" : "Unique id for inter-element referencing", "definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min" : 0, "max" : "1", "base" : { "path" : "Element.id", "min" : 0, "max" : "1" }, "type" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl" : "string" }], "code" : "http://hl7.org/fhirpath/System.String" }], "isModifier" : false, "isSummary" : false, "mapping" : [{ "identity" : "rim", "map" : "n/a" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.extension", "path" : "bcr-cancer-registration-form.treatmentEpisode.extension", "slicing" : { "discriminator" : [{ "type" : "value", "path" : "url" }], "description" : "Extensions are always sliced by (at least) url", "rules" : "open" }, "short" : "Additional content defined by implementations", "definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias" : ["extensions", "user content"], "min" : 0, "max" : "*", "base" : { "path" : "Element.extension", "min" : 0, "max" : "*" }, "type" : [{ "code" : "Extension" }], "constraint" : [{ "key" : "ele-1", "severity" : "error", "human" : "All FHIR elements must have a @value or children", "expression" : "hasValue() or (children().count() > id.count())", "xpath" : "@value|f:*|h:div", "source" : "http://hl7.org/fhir/StructureDefinition/Element" }, { "key" : "ext-1", "severity" : "error", "human" : "Must have either extensions or value[x], not both", "expression" : "extension.exists() != value.exists()", "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source" : "http://hl7.org/fhir/StructureDefinition/Extension" }], "isModifier" : false, "isSummary" : false, "mapping" : [{ "identity" : "rim", "map" : "n/a" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.modifierExtension", "path" : "bcr-cancer-registration-form.treatmentEpisode.modifierExtension", "short" : "Extensions that cannot be ignored even if unrecognized", "definition" : "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).", "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).", "alias" : ["extensions", "user content", "modifiers"], "min" : 0, "max" : "*", "base" : { "path" : "BackboneElement.modifierExtension", "min" : 0, "max" : "*" }, "type" : [{ "code" : "Extension" }], "constraint" : [{ "key" : "ele-1", "severity" : "error", "human" : "All FHIR elements must have a @value or children", "expression" : "hasValue() or (children().count() > id.count())", "xpath" : "@value|f:*|h:div", "source" : "http://hl7.org/fhir/StructureDefinition/Element" }, { "key" : "ext-1", "severity" : "error", "human" : "Must have either extensions or value[x], not both", "expression" : "extension.exists() != value.exists()", "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source" : "http://hl7.org/fhir/StructureDefinition/Extension" }], "isModifier" : true, "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them", "isSummary" : true, "mapping" : [{ "identity" : "rim", "map" : "N/A" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.code", "path" : "bcr-cancer-registration-form.treatmentEpisode.code", "short" : "Diagnosis / treatment code", "definition" : "Chronology code. Codes:\n5 = diagnosis; 10 = surgery; 11 = excision biopsy;\n16 = HSCT autologous; 17 = HSCT allogeneic;\n20 = external radiotherapy / brachytherapy; 21 = IORT; 22 = hadron therapy;\n25 = concurrent chemoradiotherapy; 26 = concurrent radio-immunotherapy;\n30 = radio-isotopes; 35 = phototherapy; 36 = topical therapy;\n40 = chemotherapy / systemic therapy; 45 = targeted therapy (not 26, 60);\n50 = hormonal therapy; 60 = immunotherapy (not 26, 66);\n66 = concurrent chemo-immunotherapy;\n70 = symptomatic / palliative; 75 = active surveillance / watchful waiting;\n80 = other treatment (free-text comment required);\n90 = no therapy; 95 = treatment refusal; 99 = unknown.", "min" : 1, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.treatmentEpisode.code", "min" : 1, "max" : "1" }, "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-treatment-chronology-vs" } }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.campusId", "path" : "bcr-cancer-registration-form.treatmentEpisode.campusId", "short" : "Campus / vestigingsnummer", "definition" : "Hospital site identifier where the episode took place.", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.treatmentEpisode.campusId", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.startDate", "path" : "bcr-cancer-registration-form.treatmentEpisode.startDate", "short" : "Start date", "definition" : "Episode start date.", "min" : 1, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.treatmentEpisode.startDate", "min" : 1, "max" : "1" }, "type" : [{ "code" : "date" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.endDate", "path" : "bcr-cancer-registration-form.treatmentEpisode.endDate", "short" : "End date", "definition" : "Episode end date when known.", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.treatmentEpisode.endDate", "min" : 0, "max" : "1" }, "type" : [{ "code" : "date" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.comment", "path" : "bcr-cancer-registration-form.treatmentEpisode.comment", "short" : "Comment", "definition" : "Free-text comment, required only for code 80 (other treatment).", "min" : 0, "max" : "1", "base" : { "path" : "bcr-cancer-registration-form.treatmentEpisode.comment", "min" : 0, "max" : "1" }, "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.mocReport", "path" : "bcr-cancer-registration-form.mocReport", "short" : "Attached MOC report(s)", "definition" : "MOC report(s) attached to the form. Only required for breast tumours per footnote 7 of Bijlage 55.", "min" : 0, "max" : "*", "base" : { "path" : "bcr-cancer-registration-form.mocReport", "min" : 0, "max" : "*" }, "type" : [{ "code" : "Attachment" }] }] }, "differential" : { "element" : [{ "id" : "bcr-cancer-registration-form", "path" : "bcr-cancer-registration-form", "short" : "BCR Cancer Registration Form — Bijlage 55 (Logical Model)", "definition" : "Logical model of the Belgian standard cancer registration form\n(*Kankerregistratieformulier voor een nieuwe diagnose*).\nThis is what hospitals submit to the Belgian Cancer Registry through WBCR\nor via batch extraction for every new cancer diagnosis.\n\nDistinct from `BCRCancerCase`, which models the *published research dataset*\nderived from these submissions plus registry follow-up.\n\nSource (canonical): Bijlage 55 to the RIZIV Verordening of 28 July 2003,\nas amended by the Verordening of 15 December 2025 (Belgisch Staatsblad\n23-12-2025, p. 96356)." }, { "id" : "bcr-cancer-registration-form.patientName", "path" : "bcr-cancer-registration-form.patientName", "short" : "Patient name", "definition" : "Free-text patient name as entered on the form.", "min" : 1, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.birthDate", "path" : "bcr-cancer-registration-form.birthDate", "short" : "Date of birth", "definition" : "Patient date of birth.", "min" : 1, "max" : "1", "type" : [{ "code" : "date" }] }, { "id" : "bcr-cancer-registration-form.nationalOrInsuranceNumber", "path" : "bcr-cancer-registration-form.nationalOrInsuranceNumber", "short" : "INSZ / Ziekenfondsnummer", "definition" : "Belgian national number (INSZ/NISS) or, when unavailable, the insurance fund number.", "min" : 1, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.sex", "path" : "bcr-cancer-registration-form.sex", "short" : "Sex", "definition" : "Sex of the patient.", "min" : 1, "max" : "1", "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-sex-at-birth-vs" } }, { "id" : "bcr-cancer-registration-form.incidenceDate", "path" : "bcr-cancer-registration-form.incidenceDate", "short" : "Incidence date", "definition" : "Date of incidence (DD-MM-YYYY) per ENCR/IACR international guidelines.", "min" : 1, "max" : "1", "type" : [{ "code" : "date" }] }, { "id" : "bcr-cancer-registration-form.basisOfDiagnosis", "path" : "bcr-cancer-registration-form.basisOfDiagnosis", "short" : "Basis for diagnosis", "definition" : "Most reliable method by which the diagnosis was established. Codes:\n2 = histology of primary tumour, 3 = histology of metastasis,\n4 = cytology / haematology, 5 = technical investigation (RX, endoscopy, …),\n6 = clinical, 7 = tumour marker (PSA, hCG, AFP, Ig, …),\n8 = cytogenetic / molecular tests, 9 = unknown.", "min" : 1, "max" : "1", "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-basis-of-diagnosis-vs" } }, { "id" : "bcr-cancer-registration-form.whoPerformanceScore", "path" : "bcr-cancer-registration-form.whoPerformanceScore", "short" : "WHO performance score at diagnosis", "definition" : "Score at incidence date. Codes:\n0 = asymptomatic, normal activity; 1 = symptomatic but ambulatory;\n2 = symptomatic, bedridden <50% per day; 3 = symptomatic, bedridden >50% per day;\n4 = fully dependent, 100% bedridden.", "min" : 0, "max" : "1", "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-who-performance-score-vs" } }, { "id" : "bcr-cancer-registration-form.primaryTumourLocation", "path" : "bcr-cancer-registration-form.primaryTumourLocation", "short" : "Primary tumour localisation", "definition" : "ICD-O-3 topography of the primary tumour.", "min" : 1, "max" : "1", "type" : [{ "code" : "code" }], "binding" : { "strength" : "extensible", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-topography-vs" } }, { "id" : "bcr-cancer-registration-form.laterality", "path" : "bcr-cancer-registration-form.laterality", "short" : "Laterality", "definition" : "Laterality of the primary tumour. Codes: 1 = left, 2 = right, 3 = unpaired organ, NK = unknown.", "min" : 0, "max" : "1", "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-laterality-vs" } }, { "id" : "bcr-cancer-registration-form.histologyMorphology", "path" : "bcr-cancer-registration-form.histologyMorphology", "short" : "Histology — morphology", "definition" : "ICD-O-3 morphology code (the part before the slash on the form).", "min" : 1, "max" : "1", "type" : [{ "code" : "code" }], "binding" : { "strength" : "extensible", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-morphology-vs" } }, { "id" : "bcr-cancer-registration-form.histologyBehaviour", "path" : "bcr-cancer-registration-form.histologyBehaviour", "short" : "Histology — behaviour", "definition" : "ICD-O-3 behaviour code (the part after the slash on the form: benign / borderline / in situ / malignant primary / malignant metastatic / unknown).", "min" : 1, "max" : "1", "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-behaviour-vs" } }, { "id" : "bcr-cancer-registration-form.differentiationGrade", "path" : "bcr-cancer-registration-form.differentiationGrade", "short" : "Differentiation grade", "definition" : "Grade of differentiation. Codes:\n1 = well, 2 = moderate, 3 = poor, 4 = undifferentiated / anaplastic,\n5 = T-cell, 6 = B-cell, 7 = null-cell (not T / not B),\n8 = NK cell, 9 = unknown.", "min" : 0, "max" : "1", "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-differentiation-grade-vs" } }, { "id" : "bcr-cancer-registration-form.clinicalT", "path" : "bcr-cancer-registration-form.clinicalT", "short" : "Clinical T (cT)", "definition" : "Clinical T category (UICC TNM).", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.clinicalN", "path" : "bcr-cancer-registration-form.clinicalN", "short" : "Clinical N (cN)", "definition" : "Clinical N category (UICC TNM).", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.clinicalM", "path" : "bcr-cancer-registration-form.clinicalM", "short" : "Clinical M (cM)", "definition" : "Clinical M category (UICC TNM).", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.pathologicalT", "path" : "bcr-cancer-registration-form.pathologicalT", "short" : "Pathological T (pT)", "definition" : "Pathological T category (UICC TNM).", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.pathologicalN", "path" : "bcr-cancer-registration-form.pathologicalN", "short" : "Pathological N (pN)", "definition" : "Pathological N category (UICC TNM).", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.pathologicalM", "path" : "bcr-cancer-registration-form.pathologicalM", "short" : "Pathological M (pM)", "definition" : "Pathological M category (UICC TNM).", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.postNeoadjuvantT", "path" : "bcr-cancer-registration-form.postNeoadjuvantT", "short" : "Post-neoadjuvant pathological T (ypT)", "definition" : "Pathological T after neoadjuvant therapy.", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.postNeoadjuvantN", "path" : "bcr-cancer-registration-form.postNeoadjuvantN", "short" : "Post-neoadjuvant pathological N (ypN)", "definition" : "Pathological N after neoadjuvant therapy.", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.postNeoadjuvantM", "path" : "bcr-cancer-registration-form.postNeoadjuvantM", "short" : "Post-neoadjuvant pathological M (ypM)", "definition" : "Pathological M after neoadjuvant therapy.", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.otherClassification", "path" : "bcr-cancer-registration-form.otherClassification", "short" : "Other classification", "definition" : "Alternative staging classification used when applicable. Codes:\n1 = Childhood Cancer Stage, 2 = FIGO, 3 = Lugano,\n4 = Breslow (in mm), 5 = other.", "min" : 0, "max" : "1", "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-other-classification-vs" } }, { "id" : "bcr-cancer-registration-form.otherStageGroup", "path" : "bcr-cancer-registration-form.otherStageGroup", "short" : "Other classification — stage", "definition" : "Stage value within the chosen alternative classification (e.g. Breslow depth in mm, FIGO stage).", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.clinicalTrialParticipation", "path" : "bcr-cancer-registration-form.clinicalTrialParticipation", "short" : "Clinical trial participation", "definition" : "Whether the cancer treatment is part of a clinical study (Ja / Nee / Onbekend).", "min" : 0, "max" : "1", "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-clinical-trial-indicator-vs" } }, { "id" : "bcr-cancer-registration-form.eudraCtNumber", "path" : "bcr-cancer-registration-form.eudraCtNumber", "short" : "EudraCT number", "definition" : "EudraCT identifier of the trial when clinical trial participation is *Ja*.", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode", "path" : "bcr-cancer-registration-form.treatmentEpisode", "short" : "Treatment chronology row", "definition" : "One row of the chronology table, filled in chronologically from incidence date and first treatment.", "min" : 0, "max" : "*", "type" : [{ "code" : "BackboneElement" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.code", "path" : "bcr-cancer-registration-form.treatmentEpisode.code", "short" : "Diagnosis / treatment code", "definition" : "Chronology code. Codes:\n5 = diagnosis; 10 = surgery; 11 = excision biopsy;\n16 = HSCT autologous; 17 = HSCT allogeneic;\n20 = external radiotherapy / brachytherapy; 21 = IORT; 22 = hadron therapy;\n25 = concurrent chemoradiotherapy; 26 = concurrent radio-immunotherapy;\n30 = radio-isotopes; 35 = phototherapy; 36 = topical therapy;\n40 = chemotherapy / systemic therapy; 45 = targeted therapy (not 26, 60);\n50 = hormonal therapy; 60 = immunotherapy (not 26, 66);\n66 = concurrent chemo-immunotherapy;\n70 = symptomatic / palliative; 75 = active surveillance / watchful waiting;\n80 = other treatment (free-text comment required);\n90 = no therapy; 95 = treatment refusal; 99 = unknown.", "min" : 1, "max" : "1", "type" : [{ "code" : "code" }], "binding" : { "strength" : "required", "valueSet" : "https://www.ehealth.fgov.be/standards/fhir/registries/bcr/ValueSet/bcr-treatment-chronology-vs" } }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.campusId", "path" : "bcr-cancer-registration-form.treatmentEpisode.campusId", "short" : "Campus / vestigingsnummer", "definition" : "Hospital site identifier where the episode took place.", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.startDate", "path" : "bcr-cancer-registration-form.treatmentEpisode.startDate", "short" : "Start date", "definition" : "Episode start date.", "min" : 1, "max" : "1", "type" : [{ "code" : "date" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.endDate", "path" : "bcr-cancer-registration-form.treatmentEpisode.endDate", "short" : "End date", "definition" : "Episode end date when known.", "min" : 0, "max" : "1", "type" : [{ "code" : "date" }] }, { "id" : "bcr-cancer-registration-form.treatmentEpisode.comment", "path" : "bcr-cancer-registration-form.treatmentEpisode.comment", "short" : "Comment", "definition" : "Free-text comment, required only for code 80 (other treatment).", "min" : 0, "max" : "1", "type" : [{ "code" : "string" }] }, { "id" : "bcr-cancer-registration-form.mocReport", "path" : "bcr-cancer-registration-form.mocReport", "short" : "Attached MOC report(s)", "definition" : "MOC report(s) attached to the form. Only required for breast tumours per footnote 7 of Bijlage 55.", "min" : 0, "max" : "*", "type" : [{ "code" : "Attachment" }] }] } }