Belgian Cancer Registry on FHIR - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Terminology

Terminology

The IG defines 23 CodeSystems and 33 ValueSets. Each coded element on each logical model is bound to a ValueSet from one of three derivation patterns, with binding strength chosen to reflect how confident we are in the source.

Pattern 1 — Form-defined enumerations (binding: required)

These ValueSets are derived directly from numbered code lists on Bijlage 55 (often in form footnotes). Each code preserves the numeric or short alphanumeric value as it appears on the form, so the IG round-trips cleanly with BCR data feeds.

ValueSet	Source	# codes
BCRBasisOfDiagnosisVS	Bijlage 55 footnote 2	8
BCRWHOPerformanceScoreVS	Bijlage 55 footnote 3	5
BCRLateralityVS	Bijlage 55 footnote 4	4 (incl. NK)
BCRDifferentiationGradeVS	Bijlage 55 footnote 5	9
BCROtherClassificationVS	Bijlage 55 footnote 6	5
BCRClinicalTrialIndicatorVS	Bijlage 55 §10A	3
BCRTreatmentChronologyVS	Bijlage 55 footnote 8	24
BCRIntendedTreatmentVS	Vervolg 3 §II	12
BCRMenopausalStatusVS	Vervolg 1 footnote 9	5
BCRMolecularMarkerVS	Vervolg 1 table headers	11
BCRLymphNodeLocationVS	Vervolg 1 §3b	3
BCRMOCReasonVS	Vervolg 2	5
BCRRecurrenceTypeVS	Vervolg 3 §I	3
BCRFollowUpMOCReasonVS	Vervolg 3 §III	6
BCRBehaviourVS	ICD-O-3 behaviour digits	6

Molecular marker results — six related ValueSets

The Vervolg 1 molecular-marker table assigns different result vocabularies to different markers (ER/PR is tri-state; HER2 IHC is 0/1+/2+/3+; gene mutations are tested/not-tested/somatic/germline; Ki-67 is a percentage). Per-marker subsets are published; BCRBreastTumourSupplement.molecularMarker.result binds to the union.

ValueSet	Applies to marker(s)
BCRMolecularMarkerResultERPRVS	ER, PR
BCRMolecularMarkerResultHER2IHCVS	HER2 IHC score
BCRMolecularMarkerResultHER2CombinedVS	HER2 status (IHC + ISH combined)
BCRMolecularMarkerResultMutationVS	BRCA1/2, CHEK2, PALB2, ATM, PIK3CA
BCRMolecularMarkerResultKi67VS	Ki-67 (categorical sentinel only — percentage uses resultPercentage)
BCRMolecularMarkerResultVS	Union — bound on the element

Pattern 2 — External standard vocabularies (binding: extensible)

For elements that reference internationally-standardised vocabularies, the IG binds to the canonical published system. ValueSet wrappers are kept thin so future filters can be applied without breaking the binding URL.

ValueSet	Code system	Used on
BCRTopographyVS	ICD-O-3 (http://terminology.hl7.org/CodeSystem/icd-o-3)	primaryTumourLocation, topography
BCRMorphologyVS	ICD-O-3	histologyMorphology, morphology
BCRICD10VS	ICD-10 (http://hl7.org/fhir/sid/icd-10)	BCRCancerCase.icd10
BCRSexAtBirthVS	FHIR administrative-gender	sex, sexAtBirth

Caveat on ICD-O-3: FHIR's published ICD-O-3 system mixes topography and morphology. Conformant data should use only the topography codes (C00–C80) for BCRTopographyVS and only morphology codes for BCRMorphologyVS. The behaviour digit is captured separately on histologyBehaviour (bound required to BCRBehaviourVS) since the form splits morphology and behaviour even though ICD-O-3 represents them as 8500/3 style joined codes.

Pattern 3 — Draft, awaiting BCR confirmation (binding: preferred)

These ValueSets cover fields that BCR's metadata describes in natural language but does not enumerate. The codes are best-effort reconstructions; descriptions explicitly say "Draft — confirm with BCR before production use". Bindings are preferred so downstream systems can override until BCR ratifies a canonical list.

ValueSet	Source field	What we drafted
BCRVitalStatusVS	BCRCancerCase.vitalStatus (fld_vs)	alive, deceased, lost-to-followup
BCRBreastTumourSequenceVS	BCRCancerCase.breastTumourSequence (borsttelling)	first-primary, subsequent
BCRRegionVS	BCRCancerCase.region, BCRChpSample.laboratoryRegion	flanders, wallonia, brussels, unknown
BCRSampleCategoryVS	BCRChpBreastSample.sampleCategory, BCRChpColonSample.sampleCategory	screening, diagnostic, followup, surveillance, other
BCRDataConfidenceLevelVS	dataConfidenceLevel (breast, colon CHP)	high, medium, low, unknown
BCRHPVTestResultVS	BCRChpCervixSample.hpvTestResult	positive, negative, inconclusive, not-done
BCRSpecimenQualityVS	BCRChpCervixSample.specimenQuality	adequate, adequate-with-limitations, inadequate
BCRHPVTypeVS	BCRChpCervixSample.hpvType (0..*)	14 high-risk + 2 low-risk WHO/IARC genotypes + other

Binding-strength summary

Strength	Used for	Behaviour
required	Pattern 1 + the small custom BCRBehaviourVS + BCRSexAtBirthVS	Any code outside the VS fails validation.
extensible	Pattern 2 (external vocabularies) + the molecular-marker result union	Codes outside the VS are allowed if no equivalent code exists in the VS.
preferred	Pattern 3 (draft)	Codes outside the VS are explicitly permitted; the VS expresses intent, not a rule.

Provenance

Every CodeSystem description cites the exact source (Bijlage 55 footnote, metadata variable name, or external system URL). The full Bijlage 55 PDF is preserved in this repository under docs/source-metadata/Bijlage55-form.pdf for round-trip auditing.