For the encoding of neoplasms in cancer Germany uses the German-language edition of the International Classification of Diseases for Oncology, third edition (ICD-O-3), first published by the World Health Organisation (WHO) in 2000. It replaced the second edition of ICD-O. DIMDI has translated ICD-O-3 into German and published as "Internationale Klassifikation der Krankheiten für die Onkologie (ICD-O-3)". Since 2019 the German-language version of ICD-O 3rd Edition, 2nd Revison of WHO is used, ICD-O-3 Zweite Revision 2019.

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ICD-O-3 Second Revision 2019

The ICD-O-3 Second Revison will replace the ICD-O-3 First Revision 2014.

Official tumour classification for cancer registries

German cancer registries have used ICD-O since the publication of the Cancer Registry Law (KRG) in 1994 and the subsequent state cancer registry laws. The German version of the ICD-O-3 does not differ from the English original. It replaces the previous version used in German tumour and cancer registries, a German expansion of ICD-O-2, the Tumour Histology Code (THS) and the Tumour Localisation Code (TLS). Many of the amendments from the THS have been integrated into the ICD-O-3.

Structure of ICD-O-3

ICD-O-3 is a dual classification. It contains both a topographical code and a histological code for each neoplasm. The topographical describes the site of the neoplasm; in general, it uses the same three- or four-character codes as used in ICD-10 for malignant neoplasms. This results in a greater accuracy in the encoding of the topography of benign tumours than achieved in ICD-10. The morphological code describes the cell type of the neoplasm and its biological behaviour. It thus characterises the neoplasm itself.

  • Introduction
    It contains introductory texts on the history of ICD-O-3, on the differences between ICD-O and ICD-10 and on the structure of ICD-O-3.
  • Instructions for use
    It contains encoding guidelines for topography and morphology together with the most important rules for the use of ICD-O-3 as well as comments and encoding examples.
  • Topography - Numerical list ("Systematik Topographie")
    The topographical section has been adapted from the section on malignant neoplasms in Chapter II of ICD-10. These topographical terms have been assigned four-character code numbers that run from C00.0 to C80.9. A decimal point (.) separates the subcategories from the three-character categories. There have been no changes in the topographical part from ICD-O-2.
  • Morphology - Numerical list ("Systematik Morphologie")
    Morphology codes are five-character codes ranging from 8000/0 to 9989/3. The first four digits indicate the histological term. The fifth digit, separated by a forward slash (/), represents the behaviour code. This describes whether a tumour is malignant or benign, whether it is a carcinoma in situ or a neoplasm of uncertain malignancy.
    In sixth place, a separate one-digit code is designated for histological grading or differentiation. For lymphoma and forms of leukaemia, this part of the code is used for the immunological characterisation (T-, B-, Null-, and NK-cell).
  • Alphabetical Index ("Alphabetisches Verzeichnis")
    The alphabetical index is used to encode the site (topography) as well as the histology (morphology). In addition, it contains nonneoplastic tumour-like lesions and precancerous conditions. Topographical codes are indicated by the letter C which is also the first digit in the code numbers of Chapter II of ICD-10. The prefix M is used to identify the morphological codes. The terms are listed under both the noun and the adjective. For example, basophil adenocarcinoma is listed under B for "basophil" and under A for "adenocarcinoma, basophil".
  • Differences in morphology codes between the Second and the Third Edition ("Anhang")
    The appendix includes a list of tumour terms now considered malignant, a list of all new morphology code numbers and a list of all terms and synonyms added to existing codes.

ICD-O-3 - Version history

This overview shows the periods of validity and areas of application for different versions of ICD-O. ICD-O in German Language is a direct translation of the English version.

Period of validity ICD-O in German language Scope of application corresponds to the English version:
since 01.01.2020 ICD-O-3 Zweite Revision 2019 Cancer Registries ICD-O,
Third Edition, Second Revision
WHO 2019
03.04.2014 - 31.12.2019 ICD-O-3 Erste Revision 2014 Cancer Registries ICD-O,
Third Edition, First Revision
WHO 2013
01.01.2013 -
ICD-O-3 Vorabversion 2013 (preliminary version) Cancer Registries ICD-O,
Third Edition, First Revision
WHO 2013
Aug. 2003 - 31.01.2013
ICD-O-3 Dritte Revision, 1. Auflage August 2003 Cancer Registries; since 2009 on the basis of  Bundeskrebsregisterdatengesetz (BKRG) in  the "Zentrum für Krebsregisterdaten" at Robert-Koch-Institut ICD-O,
Third Edition,
WHO 2000
up to Aug. 2003 ICD-O-2 since 1994 in Cancer Registries on the basis of Krebsregistergesetzes (KRG) and its extrapolation in the  Landeskrebsregistergesetze ICD-O,
Second Edition
WHO 1990


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