Essential TNM Staging course for the Eastern Mediterranean region

A training dedicated to TNM staging was organised for the WHO Eastern Mediterranean Region, where the cancer burden is increasing rapidly but has limited cancer incidence data. Patients at Istanbul University Oncology Institute.
13 November 2020

Effective data collection on cancer is essential for better outcomes. UICC with IARC and FoCP organised a training course on TNM staging to support the development of cancer registries in the Eastern Mediterranean region.

The UICC TNM Classification is an anatomically-based system that records the primary and regional nodal extent of the tumour and the absence or presence of metastases. This system of classification of cancer according to the stage of its development is a major determinant of appropriate treatment and prognosis. UICC has maintained and promoted the TNM Classification since it was developed in 1953, and it is currently in its 8th edition. 

Collecting cancer stage using the TNM Classification as part of the cancer registration efforts is vital for surveillance and well as planning and evaluating early detection and treatment interventions. Collecting cancer stage data by population-based registries is often a challenge, however, due to the unavailability or incompleteness of such data. In order to improve the comparability, quality and completeness of population-based stage data, the International Agency for Research on Cancer (IARC) developed in collaboration with UICC the Essential TNM, a simplified staging system for cancer registries when information on full Tumour, Node, Metastasis (TNM) is absent from medical records. Essential TNM does not replace the TNM Classification but was developed to facilitate data extraction by cancer registrars when complete data is not available. 

Although the cancer burden in the WHO Eastern Mediterranean Region is among the fastest-growing globally, coverage of high-quality population-based cancer incidence data remains limited. A training dedicated to staging using both TNM and Essential TNM was therefore organised for the cancer registries from the region. The course, generously supported by the Friends of Cancer Patients (FoCP), UICC’s vanguard partner took place from the 8th to the 12th of November 2020.

Over five days, 14 participants from 13 cancer registries from Algeria, Iraq, Jordan, Kuwait, Lebanon, Oman, Palestine, Saudi Arabia, Tunisia, Turkey and the United Arab Emirates followed live sessions delivered by the faculty including representatives from IARC’s Global Initiative for Cancer Registry Development, the Ministry of Health and Prevention of the United Arab Emirates and the Casablanca Cancer Registry. Each day completed a self-learning component which included videos and exercises for which feedback was provided by the faculty the next day. 

The staging course provided cancer registrars with training on how to assign Essential TNM for four cancers (breast, cervical, colorectal and prostate), in case the TNM stage group (I, II, III or IV) or the individual elements for TNM staging (T, N, M) are not available in patient medical records. Participants worked with coding guidelines and Essential TNM flowcharts, including visual aids for better understanding of the anatomy and related terms often used in clinical records.

To find out more about the TNM Classification please watch short cancer staging video series available here in six UN languages.

To learn the principles of cancer staging access free e-learning modules on TNM Classification, click here.

Last update: 
Wednesday 18 November 2020
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