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TNM content of the AJCC has been added to SNOMED in one of the last releases. In the Netherlands we miss some categories that are not used in the USA. If more countries needs this part as well we can ask them to add them to the international release. Else we are in contact with AJCC to be able to add them to our extension.

It concerns codes for all possible ycT, ycN, rT, rN and rM categories

Are there more countries that also use this part of the TNM categories and needs them in SNOMED?

Missing AJCC codes.xlsx

Contributors (10)


  1. The New Zealand Cancer Control Agency and Health New Zealand Te Whatu Ora would be very interested in this part of the AJCC being added to SNOMED international release. Thank you for raising this with us.

  2. Hi Elze de Groot ,Elizabeth Tanya Antoun  and other interested CMAG members,

    In relation to this discussion would you be able to confirm you are referring to AJCC, not the UICC classification which is used in Europe.

    Would you be able to provide use cases for these terms?



  3. hi Cathy Richardson I already had contact with AJCC. They said these were out of scope because they thought they were not used (I think in USA (wink)). These categories are also used for tumor classification in the Netherlands like the other categories that are already added.

    See this source for yc:

    "The extent of disease is classifi ed using the same T, N, and M definitions and identifi ed as posttreatment with a “yc” or “yp” prefix (ycT, ycN, ycTNM; ypT, ypN, ypTNM).
    Note that American registry systems do not have a data element to record “yc” elements, but these may be recorded in the medical record. The measured response to therapy and/or the extent of cancer after therapy may be prognostic. It is also used to guide subsequent surgery or other therapy. "

    It seems like rM and rN and rT are AJCC/UICC stages.

    I already did a request to AJCC to add this part to our National Extension, but that is not necessary if more countries use these codes and it can be added to the International edition.

  4. Elze Do you have short/sample list of codes that are missing, Or a single protocol,
    I can forward this to out college for comment on if they use those codes (or if we're limited to the same subset as US).


    1. Matt Cordell Ive added an excel in the original message above with all the specific codes (different tabs) that are missing. Not a short list unfortunately (wink) Does this help?

  5. Hi all,

    Belgium also registers the missing tumor AJCC classifications to which Elze is referring, so we would be happy if these could be added to the international edition.  

    Kind Regards, Katrien

  6. Hi CMAG members,

    Given the member input on this page, the spreadsheet provided by the Netherlands has been discussed at meeting with the AJCC. The AJCC are reviewing the content pending their possible approval for addition to SNOMED CT as part of a joint collaborative process between both organisations.

    Kind regards,


  7. Hi Cathy Richardson can I please join the CMAG group?

  8. Hi Anita Flynn , This is a Member country advisory group. Representatives are nominated via the Member Forum representative for that country. Each Member country is permitted to have representation on the group. While that is usually only one representative, on occasion two representatives are nominated. Regards, Cathy

    1. Hi  Cathy, 

      Could I nominate Anita Flynn to join the CMAG representing Ireland as well as myself.


      Theresa Barry

  9. Hi Cathy Richardson thank you for info on joining CMAG group Theresa Barry 

  10. Update for CMAG members,

    The spreadsheet provided by the Netherlands has now been discussed at a meeting with the AJCC. The AJCC have further validated the spreadsheet and approved addition to SNOMED CT of the majority of this content as part of a joint collaborative process agreed between both organisations. 

    The spreadsheet including the new additions made to SNOMED CT will be made available for the interested CMAG members following the completion of this work and sign off by both organizations.

  11. Hi Cathy,

    Belgium is interested as well to see the spreadsheet. Especially one of our University Hospitals had questions and comments on this (and also on the modelling of several neoplasms in general). Thank you, Katrien

  12. Hi, Sweden is also interested to have the spreadsheet sent by the Netherlands to AJCC. While we are on the subject, will there be a similar discussion with UICC and SNOMED CT?

  13. Hello Katrien Scheerlinck and Keng-Ling Wallin I am currently completing the addition of the new content to be added in collaboration with AJCC based on the spreadsheet from the Netherlands, with only one issue still outstanding and under discussion. I will inform the group when the date of publication in the release has been finalised.

    For the question regarding  UICC and SNOMED CT may I copy in Jim Case and Jane Millar regarding the possibility of any future developments.

    Thank you for your interest in this work which is based on on the joint agreement signed between SNOMED International and the American Joint Committee on Cancer - with permission of the American College of Surgeons, Chicago, Illinois.

  14. That would be good if Jim Case and Jane Millar can take that call. For your information, the Norwegian cancer registry, the SNOMED CT NRC and together with the Swedish SNOMED NRC and a few swedish pathologists, we had a meeting (which was a virtual meeting) with a representative from UICC in Oct 2022. They informed us that they will get back to us after they have had a discussion internally within UICC about AJCC's collaboration with SNOMED International, but we have not heard anything from them since. 

  15. At the SNOMED Business meeting in London earlier this month, the CSRWG was tasked with gathering support for the addition of UICC content into SNOMED and to prepare a project proposal.  Once we have indication that the need for this content is international in scope, we can again approach UICC to develop a plan around including this content in SNOMED CT. 

    cc: Jane Millar 

  16. Excellent! Thank you for the updated information. 

  17. New subtypes added to 1222584008 |American Joint Committee on Cancer allowable value (qualifier value)|

    Based on requests from several member countries through the Content Managers Advisory Group (CMAG), AJCC approved the addition to SNOMED CT of new cancer staging content as part of a joint collaborative process agreed between both organizations.

    Following an AJCC review of the requested new content 248 new concepts were added to SNOMED CT for publication in June 2023.