Cancer Pathology Data Sharing
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Cancer Pathology Data Sharing, published by HL7 International / Orders and Observations. This guide is not an authorized publication; it is the continuous build for version 1.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of and changes regularly. See the Directory of published versions

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Official URL: Version: 1.0.1
Draft as of 2024-04-16 Computable Name: USCancerPathologyData


The Cancer Pathology Data Sharing implementation guide (IG) reporting process documents best practices for transmitting pathology data as FHIR resource bundles and distributing them to the Central Cancer Registry (CCR) via two pathways:

  1. Laboratory Inforamation Systems (LIS) to CCR via an electronic health record (EHR) intermediary
  2. LIS to CCR directly

This publication promotes structured data collection and exchange of cancer pathology data, provides the data model, defined data items and their corresponding code and value sets. This guide specifies the collection and exchange of data specific to a cancer pathology synoptic report for public health reporting. This guide contains a library of FHIR profiles to create a cancer pathology message bundle and is compliant with FHIR Release 4.

Currently, the most successful implementation of the Cancer Pathology Data Sharing IG and Integrating the Healthcare Enterprise (IHE)/Structured Data Capture (SDC) on FHIR IG requires the integration of College of American Pathologists’ (CAP) checklists into the LIS workflow. Future iterations of this IG may allow for more flexible incorporation of non-electronic Cancer Protocols (eCP) content (such as narrative pathology reports or others); however, that capability is currently not supported.

The Health Level Seven (HL7) Orders and Observations (O&O) and Public Health Work Groups sponsor this guide.


This guide defines 8 FHIR profiles:

This guide defines 1 value set and 1 code system:


This guide leverages the NAACCR Standards for Cancer Registries Volume V, Laboratory Electronic Reporting Pathology Version 5.0, May 2020 (Revised 2020).

This guide also leverages profiles from the latest versions of:


The audience for this IG includes architects and developers of clinical and pathology laboratory health record systems as well as cancer registry systems in the US Realm. Business analysts and policy managers can also benefit from a basic understanding of the use of this cancer pathology data standard to support data flows from pathology laboratories.


This cancer pathology reporting FHIR IG has been developed by the Cancer ePathology Reporting Project in collaboration with the IHE SDC/eCP on FHIR Project, both under the O & O Work Group, and with other stakeholders. This library of FHIR resources was developed and produced through the efforts of HL7. The editors appreciate the support of all volunteers and staff associated with the creation of this document and the sponsorship of the following Work Groups: O & O, Vocabulary Work Group, Clinical Quality Information, Clinical Interoperability Council, Public Health, and Structured Documents. This guide would not have been possible without the support of the following organizations:

  • Centers for Disease Control and Prevention (CDC)
  • North American Association of Central Cancer Registries (NAACCR)
  • College of American Pathologists (CAP)
  • Lantana Consulting Group

This material contains content from SNOMED CT®. SNOMED CT is a registered trademark of the International Health Terminology Standard Development Organization (IHTSDO).

This material contains content from LOINC®. LOINC codes are copyright ©1995-2021, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. All rights reserved. See

This material contains content from the CAP. The Electronic Cancer Checklists are copyrighted by the CAP. All rights reserved.