PanCareSurPass Project HL7 FHIR Implementation Guide
1.0.0 - release 150

PanCareSurPass Project HL7 FHIR Implementation Guide, published by PanCareSurPass Project. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/pcsp/ and changes regularly. See the Directory of published versions

## : Risk Factors - XML Representation

Active as of 2026-01-16

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    <CodeSystem xmlns="http://hl7.org/fhir">
      <id value="cs-riskfactor-eu-pcsp"/>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CodeSystem cs-riskfactor-eu-pcsp</b></p><a name="cs-riskfactor-eu-pcsp"> </a><a name="hccs-riskfactor-eu-pcsp"> </a><p>This case-sensitive code system <code>http://hl7.eu/fhir/ig/pcsp/CodeSystem/cs-riskfactor-eu-pcsp</code> defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap">1.1<a name="cs-riskfactor-eu-pcsp-1.461"> </a></td><td>RT to a vol exposing the thyroid gland</td><td>RT to a vol exposing the thyroid gland</td></tr><tr><td style="white-space:nowrap">1.2<a name="cs-riskfactor-eu-pcsp-1.462"> </a></td><td>TBI</td><td>TBI</td></tr><tr><td style="white-space:nowrap">1.3<a name="cs-riskfactor-eu-pcsp-1.463"> </a></td><td>MIBG therapy (I-131 MIBG therapy)</td><td>MIBG therapy (I-131 MIBG therapy)</td></tr><tr><td style="white-space:nowrap">2.1<a name="cs-riskfactor-eu-pcsp-2.461"> </a></td><td>RT &gt;= 10 Gy to a vol exposing the breasts</td><td>RT &gt;= 10 Gy to a vol exposing the breasts</td></tr><tr><td style="white-space:nowrap">2.2<a name="cs-riskfactor-eu-pcsp-2.462"> </a></td><td>OR upper abdominal field radiation that can extend above the diaphragm likely exposing breast tissue at a young age</td><td>OR upper abdominal field radiation that can extend above the diaphragm likely exposing breast tissue at a young age</td></tr><tr><td style="white-space:nowrap">3.1<a name="cs-riskfactor-eu-pcsp-3.461"> </a></td><td>RT &gt;= 35 Gy to a vol exposing the heart</td><td>RT &gt;= 35 Gy to a vol exposing the heart</td></tr><tr><td style="white-space:nowrap">3.2<a name="cs-riskfactor-eu-pcsp-3.462"> </a></td><td>Anthracyclines (doxorubicin isotoxic equivalents)&gt;= 250 mg/m2</td><td>Anthracyclines (doxorubicin isotoxic equivalents)&gt;= 250 mg/m2</td></tr><tr><td style="white-space:nowrap">3.3<a name="cs-riskfactor-eu-pcsp-3.463"> </a></td><td>RT &gt;= 15 Gy to a vol exposing the heart AND Anthracyclines (doxorubicin isotoxic equivalents)&gt;= 100 mg/m2</td><td>RT &gt;= 15 Gy to a vol exposing the heart AND Anthracyclines (doxorubicin isotoxic equivalents)&gt;= 100 mg/m2</td></tr><tr><td style="white-space:nowrap">4.1<a name="cs-riskfactor-eu-pcsp-4.461"> </a></td><td>Alkylating agents</td><td>Alkylating agents</td></tr><tr><td style="white-space:nowrap">4.2<a name="cs-riskfactor-eu-pcsp-4.462"> </a></td><td>RT to a vol exposing the testes</td><td>RT to a vol exposing the testes</td></tr><tr><td style="white-space:nowrap">4.3<a name="cs-riskfactor-eu-pcsp-4.463"> </a></td><td>Including TBI</td><td>Including TBI</td></tr><tr><td style="white-space:nowrap">5.1<a name="cs-riskfactor-eu-pcsp-5.461"> </a></td><td>RT &gt;=12 Gy to a vol exposing the testicles</td><td>RT &gt;=12 Gy to a vol exposing the testicles</td></tr><tr><td style="white-space:nowrap">6.3<a name="cs-riskfactor-eu-pcsp-6.463"> </a></td><td>Surgery to the spinal cord, sympathetic nerves or pelvis</td><td>Surgery to the spinal cord, sympathetic nerves or pelvis</td></tr><tr><td style="white-space:nowrap">6.4<a name="cs-riskfactor-eu-pcsp-6.464"> </a></td><td>Hypogonadal</td><td>Hypogonadal</td></tr><tr><td style="white-space:nowrap">7.2<a name="cs-riskfactor-eu-pcsp-7.462"> </a></td><td>RT to a vol exposing the ovaries</td><td>RT to a vol exposing the ovaries</td></tr><tr><td style="white-space:nowrap">8.1<a name="cs-riskfactor-eu-pcsp-8.461"> </a></td><td>RT &gt;= 30 Gy to a vol exposing the head or the brain</td><td>RT &gt;= 30 Gy to a vol exposing the head or the brain</td></tr><tr><td style="white-space:nowrap">8.2<a name="cs-riskfactor-eu-pcsp-8.462"> </a></td><td>Cisplatin (with or without carboplatin &gt; 1500 mg/m2)</td><td>Cisplatin (with or without carboplatin &gt; 1500 mg/m2)</td></tr><tr><td style="white-space:nowrap">9.1<a name="cs-riskfactor-eu-pcsp-9.461"> </a></td><td>RT to a vol exposing the pancreas</td><td>RT to a vol exposing the pancreas</td></tr><tr><td style="white-space:nowrap">10.2<a name="cs-riskfactor-eu-pcsp-10.462"> </a></td><td>HSCT</td><td>HSCT</td></tr><tr><td style="white-space:nowrap">11.1<a name="cs-riskfactor-eu-pcsp-11.461"> </a></td><td>RT to a volume exposing the hypothalamus or pituatary gland</td><td>RT to a volume exposing the hypothalamus or pituatary gland</td></tr><tr><td style="white-space:nowrap">11.3<a name="cs-riskfactor-eu-pcsp-11.463"> </a></td><td>Hypothalamic or pituitary tumour</td><td>Hypothalamic or pituitary tumour</td></tr><tr><td style="white-space:nowrap">11.4<a name="cs-riskfactor-eu-pcsp-11.464"> </a></td><td>Neurosurgery of the hypothalamus or pituitary gland</td><td>Neurosurgery of the hypothalamus or pituitary gland</td></tr><tr><td style="white-space:nowrap">12.1<a name="cs-riskfactor-eu-pcsp-12.461"> </a></td><td>RT to a vol exposing the kidneys, heart and associated large vessels</td><td>RT to a vol exposing the kidneys, heart and associated large vessels</td></tr><tr><td style="white-space:nowrap">12.3<a name="cs-riskfactor-eu-pcsp-12.463"> </a></td><td>Nephrectomy</td><td>Nephrectomy</td></tr><tr><td style="white-space:nowrap">12.4<a name="cs-riskfactor-eu-pcsp-12.464"> </a></td><td>Ifosfamide</td><td>Ifosfamide</td></tr><tr><td style="white-space:nowrap">12.5<a name="cs-riskfactor-eu-pcsp-12.465"> </a></td><td>Platinium based chemotherapy</td><td>Platinium based chemotherapy</td></tr><tr><td style="white-space:nowrap">12.6<a name="cs-riskfactor-eu-pcsp-12.466"> </a></td><td>Nitrosureas</td><td>Nitrosureas</td></tr><tr><td style="white-space:nowrap">12.7<a name="cs-riskfactor-eu-pcsp-12.467"> </a></td><td>Immunosuppressives treatment and prolonged steroids as anticancer treatment (at least 4 weeks, continuously)</td><td>Immunosuppressives treatment and prolonged steroids as anticancer treatment (at least 4 weeks, continuously)</td></tr><tr><td style="white-space:nowrap">13.1<a name="cs-riskfactor-eu-pcsp-13.461"> </a></td><td>Cranial and/or spinal RT</td><td>Cranial and/or spinal RT</td></tr><tr><td style="white-space:nowrap">13.3<a name="cs-riskfactor-eu-pcsp-13.463"> </a></td><td>Methotrexate</td><td>Methotrexate</td></tr><tr><td style="white-space:nowrap">13.4<a name="cs-riskfactor-eu-pcsp-13.464"> </a></td><td>Gonadal failure</td><td>Gonadal failure</td></tr><tr><td style="white-space:nowrap">13.5<a name="cs-riskfactor-eu-pcsp-13.465"> </a></td><td>Growth hormone deficiency</td><td>Growth hormone deficiency</td></tr><tr><td style="white-space:nowrap">13.6<a name="cs-riskfactor-eu-pcsp-13.466"> </a></td><td>Prolonged (at least 4 weeks, continuously) corticosteroids as anti-cancer treatment</td><td>Prolonged (at least 4 weeks, continuously) corticosteroids as anti-cancer treatment</td></tr><tr><td style="white-space:nowrap">13.7<a name="cs-riskfactor-eu-pcsp-13.467"> </a></td><td>HSCT, especially with an history of GVHD</td><td>HSCT, especially with an history of GVHD</td></tr><tr><td style="white-space:nowrap">14.3<a name="cs-riskfactor-eu-pcsp-14.463"> </a></td><td>High dose RT</td><td>High dose RT</td></tr><tr><td style="white-space:nowrap">15.1<a name="cs-riskfactor-eu-pcsp-15.461"> </a></td><td>Radiotherapy to a vol exposing the HP region &gt;= 30 Gy</td><td>Radiotherapy to a vol exposing the HP region &gt;= 30 Gy</td></tr><tr><td style="white-space:nowrap">15.2<a name="cs-riskfactor-eu-pcsp-15.462"> </a></td><td>Surgery near or within the HP region</td><td>Surgery near or within the HP region</td></tr><tr><td style="white-space:nowrap">15.3<a name="cs-riskfactor-eu-pcsp-15.463"> </a></td><td>CNS tumours near or within the HP region</td><td>CNS tumours near or within the HP region</td></tr><tr><td style="white-space:nowrap">16.1<a name="cs-riskfactor-eu-pcsp-16.461"> </a></td><td>Radiotherapy to a vol exposing the HP region&lt; 30 Gy</td><td>Radiotherapy to a vol exposing the HP region&lt; 30 Gy</td></tr><tr><td style="white-space:nowrap">16.2<a name="cs-riskfactor-eu-pcsp-16.462"> </a></td><td>Hydrocephalus or cerebrospinal fluid shunt(Risk factor for GHD)</td><td>Hydrocephalus or cerebrospinal fluid shunt(Risk factor for GHD)</td></tr><tr><td style="white-space:nowrap">17.1<a name="cs-riskfactor-eu-pcsp-17.461"> </a></td><td>Radiotherapy to a vol exposing the HP region</td><td>Radiotherapy to a vol exposing the HP region</td></tr><tr><td style="white-space:nowrap">17.5<a name="cs-riskfactor-eu-pcsp-17.465"> </a></td><td>hydrocephalus or cerebrospinal fluid shunt</td><td>hydrocephalus or cerebrospinal fluid shunt</td></tr><tr><td style="white-space:nowrap">19.3<a name="cs-riskfactor-eu-pcsp-19.463"> </a></td><td>Radioiodine therapy (I-131 ablation therapy)</td><td>Radioiodine therapy (I-131 ablation therapy)</td></tr><tr><td style="white-space:nowrap">19.5<a name="cs-riskfactor-eu-pcsp-19.465"> </a></td><td>Allogenic HSCT</td><td>Allogenic HSCT</td></tr><tr><td style="white-space:nowrap">19.6<a name="cs-riskfactor-eu-pcsp-19.466"> </a></td><td>Total thyroidectomy</td><td>Total thyroidectomy</td></tr><tr><td style="white-space:nowrap">20.1<a name="cs-riskfactor-eu-pcsp-20.461"> </a></td><td>RT to a vol exposing the head, brain or neck</td><td>RT to a vol exposing the head, brain or neck</td></tr><tr><td style="white-space:nowrap">21.1<a name="cs-riskfactor-eu-pcsp-21.461"> </a></td><td>History of a central nervous system tumor</td><td>History of a central nervous system tumor</td></tr><tr><td style="white-space:nowrap">21.2<a name="cs-riskfactor-eu-pcsp-21.462"> </a></td><td>RT to a vol exposing the brain ANY DOSE</td><td>RT to a vol exposing the brain ANY DOSE</td></tr><tr><td style="white-space:nowrap">21.4<a name="cs-riskfactor-eu-pcsp-21.464"> </a></td><td>Brain surgery</td><td>Brain surgery</td></tr><tr><td style="white-space:nowrap">21.5<a name="cs-riskfactor-eu-pcsp-21.465"> </a></td><td>High dose cytarabine IV (intravenous)</td><td>High dose cytarabine IV (intravenous)</td></tr><tr><td style="white-space:nowrap">21.6<a name="cs-riskfactor-eu-pcsp-21.466"> </a></td><td>High dose MTX IV</td><td>High dose MTX IV</td></tr><tr><td style="white-space:nowrap">21.7<a name="cs-riskfactor-eu-pcsp-21.467"> </a></td><td>Any Chemotherapy IT (intrathecal)</td><td>Any Chemotherapy IT (intrathecal)</td></tr><tr><td style="white-space:nowrap">22.1<a name="cs-riskfactor-eu-pcsp-22.461"> </a></td><td>Vinca-Alkaloids</td><td>Vinca-Alkaloids</td></tr><tr><td style="white-space:nowrap">22.2<a name="cs-riskfactor-eu-pcsp-22.462"> </a></td><td>Cisplatin or carboplatin</td><td>Cisplatin or carboplatin</td></tr><tr><td style="white-space:nowrap">23.1<a name="cs-riskfactor-eu-pcsp-23.461"> </a></td><td>RT to a vol exposing the lens</td><td>RT to a vol exposing the lens</td></tr><tr><td style="white-space:nowrap">24.1<a name="cs-riskfactor-eu-pcsp-24.461"> </a></td><td>RT to a vol exposing the eye and orbit</td><td>RT to a vol exposing the eye and orbit</td></tr><tr><td style="white-space:nowrap">25.1<a name="cs-riskfactor-eu-pcsp-25.461"> </a></td><td>RT to a vol exposing the craniofacial area, especially after high doses and at a young age</td><td>RT to a vol exposing the craniofacial area, especially after high doses and at a young age</td></tr><tr><td style="white-space:nowrap">25.3<a name="cs-riskfactor-eu-pcsp-25.463"> </a></td><td>Surgery to the face, especially at a young age</td><td>Surgery to the face, especially at a young age</td></tr><tr><td style="white-space:nowrap">26.1<a name="cs-riskfactor-eu-pcsp-26.461"> </a></td><td>Surgery of the spine</td><td>Surgery of the spine</td></tr><tr><td style="white-space:nowrap">26.2<a name="cs-riskfactor-eu-pcsp-26.462"> </a></td><td>Surgery of the chest (Does not include CVC pose)</td><td>Surgery of the chest (Does not include CVC pose)</td></tr><tr><td style="white-space:nowrap">26.3<a name="cs-riskfactor-eu-pcsp-26.463"> </a></td><td>RT to a vol exposing the spine</td><td>RT to a vol exposing the spine</td></tr><tr><td style="white-space:nowrap">26.4<a name="cs-riskfactor-eu-pcsp-26.464"> </a></td><td>Spinal or paraspinal malignancies</td><td>Spinal or paraspinal malignancies</td></tr><tr><td style="white-space:nowrap">27.1<a name="cs-riskfactor-eu-pcsp-27.461"> </a></td><td>Cyclophosphamide</td><td>Cyclophosphamide</td></tr><tr><td style="white-space:nowrap">27.3<a name="cs-riskfactor-eu-pcsp-27.463"> </a></td><td>RT to a vol exposing the bladder</td><td>RT to a vol exposing the bladder</td></tr><tr><td style="white-space:nowrap">27.5<a name="cs-riskfactor-eu-pcsp-27.465"> </a></td><td>Cystectomy</td><td>Cystectomy</td></tr><tr><td style="white-space:nowrap">27.6<a name="cs-riskfactor-eu-pcsp-27.466"> </a></td><td>Hysterectomy</td><td>Hysterectomy</td></tr><tr><td style="white-space:nowrap">27.7<a name="cs-riskfactor-eu-pcsp-27.467"> </a></td><td>Pelvic surgery</td><td>Pelvic surgery</td></tr><tr><td style="white-space:nowrap">27.8<a name="cs-riskfactor-eu-pcsp-27.468"> </a></td><td>Spinal cord surgery</td><td>Spinal cord surgery</td></tr><tr><td style="white-space:nowrap">28.1<a name="cs-riskfactor-eu-pcsp-28.461"> </a></td><td>RT to a vol exposing the uterus only female</td><td>RT to a vol exposing the uterus only female</td></tr><tr><td style="white-space:nowrap">29.1<a name="cs-riskfactor-eu-pcsp-29.461"> </a></td><td>RT to a vol exposing the oral cavity or salivary glands</td><td>RT to a vol exposing the oral cavity or salivary glands</td></tr><tr><td style="white-space:nowrap">29.4<a name="cs-riskfactor-eu-pcsp-29.464"> </a></td><td>Chemotherapy</td><td>Chemotherapy</td></tr><tr><td style="white-space:nowrap">30.1<a name="cs-riskfactor-eu-pcsp-30.461"> </a></td><td>RT to a vol exposing the gastro-intestinal tract</td><td>RT to a vol exposing the gastro-intestinal tract</td></tr><tr><td style="white-space:nowrap">30.3<a name="cs-riskfactor-eu-pcsp-30.463"> </a></td><td>Oesophageal surgery</td><td>Oesophageal surgery</td></tr><tr><td style="white-space:nowrap">30.4<a name="cs-riskfactor-eu-pcsp-30.464"> </a></td><td>Abdominal surgery</td><td>Abdominal surgery</td></tr><tr><td style="white-space:nowrap">30.5<a name="cs-riskfactor-eu-pcsp-30.465"> </a></td><td>With a history of chronic GVHD</td><td>With a history of chronic GVHD</td></tr><tr><td style="white-space:nowrap">31.1<a name="cs-riskfactor-eu-pcsp-31.461"> </a></td><td>Anthracyclines (doxorubicin isotoxic equivalents) &lt;100 mg/m2</td><td>Anthracyclines (doxorubicin isotoxic equivalents) &lt;100 mg/m2</td></tr><tr><td style="white-space:nowrap">32.1<a name="cs-riskfactor-eu-pcsp-32.461"> </a></td><td>RT to a vol exposing the lungs</td><td>RT to a vol exposing the lungs</td></tr><tr><td style="white-space:nowrap">32.3<a name="cs-riskfactor-eu-pcsp-32.463"> </a></td><td>Bleomycin</td><td>Bleomycin</td></tr><tr><td style="white-space:nowrap">32.4<a name="cs-riskfactor-eu-pcsp-32.464"> </a></td><td>Busulfan</td><td>Busulfan</td></tr><tr><td style="white-space:nowrap">32.5<a name="cs-riskfactor-eu-pcsp-32.465"> </a></td><td>BCNU Carmustine</td><td>BCNU Carmustine</td></tr><tr><td style="white-space:nowrap">32.6<a name="cs-riskfactor-eu-pcsp-32.466"> </a></td><td>CCNU Lomustine</td><td>CCNU Lomustine</td></tr><tr><td style="white-space:nowrap">32.7<a name="cs-riskfactor-eu-pcsp-32.467"> </a></td><td>Thoracic surgery</td><td>Thoracic surgery</td></tr><tr><td style="white-space:nowrap">33.1<a name="cs-riskfactor-eu-pcsp-33.461"> </a></td><td>Cisplatin Any dose</td><td>Cisplatin Any dose</td></tr><tr><td style="white-space:nowrap">33.2<a name="cs-riskfactor-eu-pcsp-33.462"> </a></td><td>Ifosfamide Any dose</td><td>Ifosfamide Any dose</td></tr><tr><td style="white-space:nowrap">33.3<a name="cs-riskfactor-eu-pcsp-33.463"> </a></td><td>Carboplatin Any dose</td><td>Carboplatin Any dose</td></tr><tr><td style="white-space:nowrap">34.1<a name="cs-riskfactor-eu-pcsp-34.461"> </a></td><td>RT to a volume exposing the liver</td><td>RT to a volume exposing the liver</td></tr><tr><td style="white-space:nowrap">34.10<a name="cs-riskfactor-eu-pcsp-34.4610"> </a></td><td>Chronic GVHD</td><td>Chronic GVHD</td></tr><tr><td style="white-space:nowrap">34.11<a name="cs-riskfactor-eu-pcsp-34.4611"> </a></td><td>Liver surgery</td><td>Liver surgery</td></tr><tr><td style="white-space:nowrap">34.3<a name="cs-riskfactor-eu-pcsp-34.463"> </a></td><td>HSCT (irrespective of GVHD)</td><td>HSCT (irrespective of GVHD)</td></tr><tr><td style="white-space:nowrap">34.5<a name="cs-riskfactor-eu-pcsp-34.465"> </a></td><td>Mercaptopurine Thioguanine</td><td>Mercaptopurine Thioguanine</td></tr><tr><td style="white-space:nowrap">34.6<a name="cs-riskfactor-eu-pcsp-34.466"> </a></td><td>Dactinomycin</td><td>Dactinomycin</td></tr><tr><td style="white-space:nowrap">34.8<a name="cs-riskfactor-eu-pcsp-34.468"> </a></td><td>Chronic viral hepatitis</td><td>Chronic viral hepatitis</td></tr><tr><td style="white-space:nowrap">34.9<a name="cs-riskfactor-eu-pcsp-34.469"> </a></td><td>Sinusoidal obstruction syndrome</td><td>Sinusoidal obstruction syndrome</td></tr><tr><td style="white-space:nowrap">35.1<a name="cs-riskfactor-eu-pcsp-35.461"> </a></td><td>HSCT (irrespective of GVHD)</td><td>HSCT (irrespective of GVHD)</td></tr><tr><td style="white-space:nowrap">35.2<a name="cs-riskfactor-eu-pcsp-35.462"> </a></td><td>Multiple red blood cell transfusions</td><td>Multiple red blood cell transfusions</td></tr><tr><td style="white-space:nowrap">36.1<a name="cs-riskfactor-eu-pcsp-36.461"> </a></td><td>Splenectomy</td><td>Splenectomy</td></tr><tr><td style="white-space:nowrap">36.2<a name="cs-riskfactor-eu-pcsp-36.462"> </a></td><td>RT &gt;= 10 Gy to a vol exposing the spleen</td><td>RT &gt;= 10 Gy to a vol exposing the spleen</td></tr><tr><td style="white-space:nowrap">36.3<a name="cs-riskfactor-eu-pcsp-36.463"> </a></td><td>Allogenic HSCT (with or without TBI)</td><td>Allogenic HSCT (with or without TBI)</td></tr><tr><td style="white-space:nowrap">36.4<a name="cs-riskfactor-eu-pcsp-36.464"> </a></td><td>Autologus HSCT conditioned with TBI</td><td>Autologus HSCT conditioned with TBI</td></tr><tr><td style="white-space:nowrap">37.1<a name="cs-riskfactor-eu-pcsp-37.461"> </a></td><td>Hereditary cancer sd</td><td>Hereditary cancer sd</td></tr><tr><td style="white-space:nowrap">38.1<a name="cs-riskfactor-eu-pcsp-38.461"> </a></td><td>Any RT including TBI (predominantly in the RT field)</td><td>Any RT including TBI (predominantly in the RT field)</td></tr><tr><td style="white-space:nowrap">38.2<a name="cs-riskfactor-eu-pcsp-38.462"> </a></td><td>HSCT Especially with a history of skin GvHD</td><td>HSCT Especially with a history of skin GvHD</td></tr><tr><td style="white-space:nowrap">39.1<a name="cs-riskfactor-eu-pcsp-39.461"> </a></td><td>RT to a vol exposing the colon and rectum</td><td>RT to a vol exposing the colon and rectum</td></tr><tr><td style="white-space:nowrap">40.1<a name="cs-riskfactor-eu-pcsp-40.461"> </a></td><td>RT to a vol exposing the oral cavity</td><td>RT to a vol exposing the oral cavity</td></tr><tr><td style="white-space:nowrap">41.2<a name="cs-riskfactor-eu-pcsp-41.462"> </a></td><td>Anthracyclines and/or Mitoxantrone</td><td>Anthracyclines and/or Mitoxantrone</td></tr><tr><td style="white-space:nowrap">41.3<a name="cs-riskfactor-eu-pcsp-41.463"> </a></td><td>Epipodophyllotoxins or autologous</td><td>Epipodophyllotoxins or autologous</td></tr><tr><td style="white-space:nowrap">41.4<a name="cs-riskfactor-eu-pcsp-41.464"> </a></td><td>Autologous haematopoietic stem cell transplant</td><td>Autologous haematopoietic stem cell transplant</td></tr><tr><td style="white-space:nowrap">42.1<a name="cs-riskfactor-eu-pcsp-42.461"> </a></td><td>Ciclofosfamide, Ifosfamide (particularly if they have a history of severe hemorrhagic cystitis)</td><td>Ciclofosfamide, Ifosfamide (particularly if they have a history of severe hemorrhagic cystitis)</td></tr><tr><td style="white-space:nowrap">45.1<a name="cs-riskfactor-eu-pcsp-45.461"> </a></td><td>RT to a vol exposing the head or brain</td><td>RT to a vol exposing the head or brain</td></tr><tr><td style="white-space:nowrap">46.1<a name="cs-riskfactor-eu-pcsp-46.461"> </a></td><td>RT between 15 and 35 Gy to a vol exposing the heart</td><td>RT between 15 and 35 Gy to a vol exposing the heart</td></tr><tr><td style="white-space:nowrap">46.2<a name="cs-riskfactor-eu-pcsp-46.462"> </a></td><td>Anthracyclines (doxorubicin isotoxic equivalents) between 100 and 250 mg/m2</td><td>Anthracyclines (doxorubicin isotoxic equivalents) between 100 and 250 mg/m2</td></tr><tr><td style="white-space:nowrap">47.1<a name="cs-riskfactor-eu-pcsp-47.461"> </a></td><td>RT to a vol exposing the kidney or urinary tract</td><td>RT to a vol exposing the kidney or urinary tract</td></tr></table></div>
      </text>
      <url value="http://hl7.eu/fhir/ig/pcsp/CodeSystem/cs-riskfactor-eu-pcsp"/>
      <version value="1.0.0"/>
      <name value="CsRiskFactorPcsp"/>
      <title value="Risk Factors"/>
      <status value="active"/>
      <experimental value="false"/>
      <date value="2026-01-16T12:01:48+00:00"/>
      <publisher value="PanCareSurPass Project"/>
      <contact>
        <name value="PanCareSurPass Project"/>
        <telecom>
          <system value="url"/>
          <value value="https://www.pancaresurpass.eu/"/>
        </telecom>
      </contact>
      <contact>
        <name value="PanCareSurPass Project"/>
        <telecom>
          <system value="url"/>
          <value value="https://www.pancaresurpass.eu/"/>
        </telecom>
      </contact>
      <description value="Risk Factors used by the PCSP algorithm"/>
      <jurisdiction>
        <coding>
          <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
          <code value="150"/>
          <display value="Europe"/>
        </coding>
      </jurisdiction>
      <caseSensitive value="true"/>
      <content value="complete"/>
      <count value="112"/>
      <concept>
        <code value="1.1"/>
        <display value="RT to a vol exposing the thyroid gland"/>
        <definition value="RT to a vol exposing the thyroid gland"/>
      </concept>
      <concept>
        <code value="1.2"/>
        <display value="TBI"/>
        <definition value="TBI"/>
      </concept>
      <concept>
        <code value="1.3"/>
        <display value="MIBG therapy (I-131 MIBG therapy)"/>
        <definition value="MIBG therapy (I-131 MIBG therapy)"/>
      </concept>
      <concept>
        <code value="2.1"/>
        <display value="RT &gt;= 10 Gy to a vol exposing the breasts"/>
        <definition value="RT &gt;= 10 Gy to a vol exposing the breasts"/>
      </concept>
      <concept>
        <code value="2.2"/>
        <display
                 value="OR upper abdominal field radiation that can extend above the diaphragm likely exposing breast tissue at a young age"/>
        <definition
                    value="OR upper abdominal field radiation that can extend above the diaphragm likely exposing breast tissue at a young age"/>
      </concept>
      <concept>
        <code value="3.1"/>
        <display value="RT &gt;= 35 Gy to a vol exposing the heart"/>
        <definition value="RT &gt;= 35 Gy to a vol exposing the heart"/>
      </concept>
      <concept>
        <code value="3.2"/>
        <display
                 value="Anthracyclines (doxorubicin isotoxic equivalents)&gt;= 250 mg/m2"/>
        <definition
                    value="Anthracyclines (doxorubicin isotoxic equivalents)&gt;= 250 mg/m2"/>
      </concept>
      <concept>
        <code value="3.3"/>
        <display
                 value="RT &gt;= 15 Gy to a vol exposing the heart AND Anthracyclines (doxorubicin isotoxic equivalents)&gt;= 100 mg/m2"/>
        <definition
                    value="RT &gt;= 15 Gy to a vol exposing the heart AND Anthracyclines (doxorubicin isotoxic equivalents)&gt;= 100 mg/m2"/>
      </concept>
      <concept>
        <code value="4.1"/>
        <display value="Alkylating agents"/>
        <definition value="Alkylating agents"/>
      </concept>
      <concept>
        <code value="4.2"/>
        <display value="RT to a vol exposing the testes"/>
        <definition value="RT to a vol exposing the testes"/>
      </concept>
      <concept>
        <code value="4.3"/>
        <display value="Including TBI"/>
        <definition value="Including TBI"/>
      </concept>
      <concept>
        <code value="5.1"/>
        <display value="RT &gt;=12 Gy to a vol exposing the testicles"/>
        <definition value="RT &gt;=12 Gy to a vol exposing the testicles"/>
      </concept>
      <concept>
        <code value="6.3"/>
        <display
                 value="Surgery to the spinal cord, sympathetic nerves or pelvis"/>
        <definition
                    value="Surgery to the spinal cord, sympathetic nerves or pelvis"/>
      </concept>
      <concept>
        <code value="6.4"/>
        <display value="Hypogonadal"/>
        <definition value="Hypogonadal"/>
      </concept>
      <concept>
        <code value="7.2"/>
        <display value="RT to a vol exposing the ovaries"/>
        <definition value="RT to a vol exposing the ovaries"/>
      </concept>
      <concept>
        <code value="8.1"/>
        <display value="RT &gt;= 30 Gy to a vol exposing the head or the brain"/>
        <definition
                    value="RT &gt;= 30 Gy to a vol exposing the head or the brain"/>
      </concept>
      <concept>
        <code value="8.2"/>
        <display value="Cisplatin (with or without carboplatin &gt; 1500 mg/m2)"/>
        <definition
                    value="Cisplatin (with or without carboplatin &gt; 1500 mg/m2)"/>
      </concept>
      <concept>
        <code value="9.1"/>
        <display value="RT to a vol exposing the pancreas"/>
        <definition value="RT to a vol exposing the pancreas"/>
      </concept>
      <concept>
        <code value="10.2"/>
        <display value="HSCT"/>
        <definition value="HSCT"/>
      </concept>
      <concept>
        <code value="11.1"/>
        <display
                 value="RT to a volume exposing the hypothalamus or pituatary gland"/>
        <definition
                    value="RT to a volume exposing the hypothalamus or pituatary gland"/>
      </concept>
      <concept>
        <code value="11.3"/>
        <display value="Hypothalamic or pituitary tumour"/>
        <definition value="Hypothalamic or pituitary tumour"/>
      </concept>
      <concept>
        <code value="11.4"/>
        <display value="Neurosurgery of the hypothalamus or pituitary gland"/>
        <definition value="Neurosurgery of the hypothalamus or pituitary gland"/>
      </concept>
      <concept>
        <code value="12.1"/>
        <display
                 value="RT to a vol exposing the kidneys, heart and associated large vessels"/>
        <definition
                    value="RT to a vol exposing the kidneys, heart and associated large vessels"/>
      </concept>
      <concept>
        <code value="12.3"/>
        <display value="Nephrectomy"/>
        <definition value="Nephrectomy"/>
      </concept>
      <concept>
        <code value="12.4"/>
        <display value="Ifosfamide"/>
        <definition value="Ifosfamide"/>
      </concept>
      <concept>
        <code value="12.5"/>
        <display value="Platinium based chemotherapy"/>
        <definition value="Platinium based chemotherapy"/>
      </concept>
      <concept>
        <code value="12.6"/>
        <display value="Nitrosureas"/>
        <definition value="Nitrosureas"/>
      </concept>
      <concept>
        <code value="12.7"/>
        <display
                 value="Immunosuppressives treatment and prolonged steroids as anticancer treatment (at least 4 weeks, continuously)"/>
        <definition
                    value="Immunosuppressives treatment and prolonged steroids as anticancer treatment (at least 4 weeks, continuously)"/>
      </concept>
      <concept>
        <code value="13.1"/>
        <display value="Cranial and/or spinal RT"/>
        <definition value="Cranial and/or spinal RT"/>
      </concept>
      <concept>
        <code value="13.3"/>
        <display value="Methotrexate"/>
        <definition value="Methotrexate"/>
      </concept>
      <concept>
        <code value="13.4"/>
        <display value="Gonadal failure"/>
        <definition value="Gonadal failure"/>
      </concept>
      <concept>
        <code value="13.5"/>
        <display value="Growth hormone deficiency"/>
        <definition value="Growth hormone deficiency"/>
      </concept>
      <concept>
        <code value="13.6"/>
        <display
                 value="Prolonged (at least 4 weeks, continuously) corticosteroids as anti-cancer treatment"/>
        <definition
                    value="Prolonged (at least 4 weeks, continuously) corticosteroids as anti-cancer treatment"/>
      </concept>
      <concept>
        <code value="13.7"/>
        <display value="HSCT, especially with an history of GVHD"/>
        <definition value="HSCT, especially with an history of GVHD"/>
      </concept>
      <concept>
        <code value="14.3"/>
        <display value="High dose RT"/>
        <definition value="High dose RT"/>
      </concept>
      <concept>
        <code value="15.1"/>
        <display
                 value="Radiotherapy to a vol exposing the HP region &gt;= 30 Gy"/>
        <definition
                    value="Radiotherapy to a vol exposing the HP region &gt;= 30 Gy"/>
      </concept>
      <concept>
        <code value="15.2"/>
        <display value="Surgery near or within the HP region"/>
        <definition value="Surgery near or within the HP region"/>
      </concept>
      <concept>
        <code value="15.3"/>
        <display value="CNS tumours near or within the HP region"/>
        <definition value="CNS tumours near or within the HP region"/>
      </concept>
      <concept>
        <code value="16.1"/>
        <display value="Radiotherapy to a vol exposing the HP region&lt; 30 Gy"/>
        <definition
                    value="Radiotherapy to a vol exposing the HP region&lt; 30 Gy"/>
      </concept>
      <concept>
        <code value="16.2"/>
        <display
                 value="Hydrocephalus or cerebrospinal fluid shunt(Risk factor for GHD)"/>
        <definition
                    value="Hydrocephalus or cerebrospinal fluid shunt(Risk factor for GHD)"/>
      </concept>
      <concept>
        <code value="17.1"/>
        <display value="Radiotherapy to a vol exposing the HP region"/>
        <definition value="Radiotherapy to a vol exposing the HP region"/>
      </concept>
      <concept>
        <code value="17.5"/>
        <display value="hydrocephalus or cerebrospinal fluid shunt"/>
        <definition value="hydrocephalus or cerebrospinal fluid shunt"/>
      </concept>
      <concept>
        <code value="19.3"/>
        <display value="Radioiodine therapy (I-131 ablation therapy)"/>
        <definition value="Radioiodine therapy (I-131 ablation therapy)"/>
      </concept>
      <concept>
        <code value="19.5"/>
        <display value="Allogenic HSCT"/>
        <definition value="Allogenic HSCT"/>
      </concept>
      <concept>
        <code value="19.6"/>
        <display value="Total thyroidectomy"/>
        <definition value="Total thyroidectomy"/>
      </concept>
      <concept>
        <code value="20.1"/>
        <display value="RT to a vol exposing the head, brain or neck"/>
        <definition value="RT to a vol exposing the head, brain or neck"/>
      </concept>
      <concept>
        <code value="21.1"/>
        <display value="History of a central nervous system tumor"/>
        <definition value="History of a central nervous system tumor"/>
      </concept>
      <concept>
        <code value="21.2"/>
        <display value="RT to a vol exposing the brain ANY DOSE"/>
        <definition value="RT to a vol exposing the brain ANY DOSE"/>
      </concept>
      <concept>
        <code value="21.4"/>
        <display value="Brain surgery"/>
        <definition value="Brain surgery"/>
      </concept>
      <concept>
        <code value="21.5"/>
        <display value="High dose cytarabine IV (intravenous)"/>
        <definition value="High dose cytarabine IV (intravenous)"/>
      </concept>
      <concept>
        <code value="21.6"/>
        <display value="High dose MTX IV"/>
        <definition value="High dose MTX IV"/>
      </concept>
      <concept>
        <code value="21.7"/>
        <display value="Any Chemotherapy IT (intrathecal)"/>
        <definition value="Any Chemotherapy IT (intrathecal)"/>
      </concept>
      <concept>
        <code value="22.1"/>
        <display value="Vinca-Alkaloids"/>
        <definition value="Vinca-Alkaloids"/>
      </concept>
      <concept>
        <code value="22.2"/>
        <display value="Cisplatin or carboplatin"/>
        <definition value="Cisplatin or carboplatin"/>
      </concept>
      <concept>
        <code value="23.1"/>
        <display value="RT to a vol exposing the lens"/>
        <definition value="RT to a vol exposing the lens"/>
      </concept>
      <concept>
        <code value="24.1"/>
        <display value="RT to a vol exposing the eye and orbit"/>
        <definition value="RT to a vol exposing the eye and orbit"/>
      </concept>
      <concept>
        <code value="25.1"/>
        <display
                 value="RT to a vol exposing the craniofacial area, especially after high doses and at a young age"/>
        <definition
                    value="RT to a vol exposing the craniofacial area, especially after high doses and at a young age"/>
      </concept>
      <concept>
        <code value="25.3"/>
        <display value="Surgery to the face, especially at a young age"/>
        <definition value="Surgery to the face, especially at a young age"/>
      </concept>
      <concept>
        <code value="26.1"/>
        <display value="Surgery of the spine"/>
        <definition value="Surgery of the spine"/>
      </concept>
      <concept>
        <code value="26.2"/>
        <display value="Surgery of the chest (Does not include CVC pose)"/>
        <definition value="Surgery of the chest (Does not include CVC pose)"/>
      </concept>
      <concept>
        <code value="26.3"/>
        <display value="RT to a vol exposing the spine"/>
        <definition value="RT to a vol exposing the spine"/>
      </concept>
      <concept>
        <code value="26.4"/>
        <display value="Spinal or paraspinal malignancies"/>
        <definition value="Spinal or paraspinal malignancies"/>
      </concept>
      <concept>
        <code value="27.1"/>
        <display value="Cyclophosphamide"/>
        <definition value="Cyclophosphamide"/>
      </concept>
      <concept>
        <code value="27.3"/>
        <display value="RT to a vol exposing the bladder"/>
        <definition value="RT to a vol exposing the bladder"/>
      </concept>
      <concept>
        <code value="27.5"/>
        <display value="Cystectomy"/>
        <definition value="Cystectomy"/>
      </concept>
      <concept>
        <code value="27.6"/>
        <display value="Hysterectomy"/>
        <definition value="Hysterectomy"/>
      </concept>
      <concept>
        <code value="27.7"/>
        <display value="Pelvic surgery"/>
        <definition value="Pelvic surgery"/>
      </concept>
      <concept>
        <code value="27.8"/>
        <display value="Spinal cord surgery"/>
        <definition value="Spinal cord surgery"/>
      </concept>
      <concept>
        <code value="28.1"/>
        <display value="RT to a vol exposing the uterus only female"/>
        <definition value="RT to a vol exposing the uterus only female"/>
      </concept>
      <concept>
        <code value="29.1"/>
        <display value="RT to a vol exposing the oral cavity or salivary glands"/>
        <definition
                    value="RT to a vol exposing the oral cavity or salivary glands"/>
      </concept>
      <concept>
        <code value="29.4"/>
        <display value="Chemotherapy"/>
        <definition value="Chemotherapy"/>
      </concept>
      <concept>
        <code value="30.1"/>
        <display value="RT to a vol exposing the gastro-intestinal tract"/>
        <definition value="RT to a vol exposing the gastro-intestinal tract"/>
      </concept>
      <concept>
        <code value="30.3"/>
        <display value="Oesophageal surgery"/>
        <definition value="Oesophageal surgery"/>
      </concept>
      <concept>
        <code value="30.4"/>
        <display value="Abdominal surgery"/>
        <definition value="Abdominal surgery"/>
      </concept>
      <concept>
        <code value="30.5"/>
        <display value="With a history of chronic GVHD"/>
        <definition value="With a history of chronic GVHD"/>
      </concept>
      <concept>
        <code value="31.1"/>
        <display
                 value="Anthracyclines (doxorubicin isotoxic equivalents) &lt;100 mg/m2"/>
        <definition
                    value="Anthracyclines (doxorubicin isotoxic equivalents) &lt;100 mg/m2"/>
      </concept>
      <concept>
        <code value="32.1"/>
        <display value="RT to a vol exposing the lungs"/>
        <definition value="RT to a vol exposing the lungs"/>
      </concept>
      <concept>
        <code value="32.3"/>
        <display value="Bleomycin"/>
        <definition value="Bleomycin"/>
      </concept>
      <concept>
        <code value="32.4"/>
        <display value="Busulfan"/>
        <definition value="Busulfan"/>
      </concept>
      <concept>
        <code value="32.5"/>
        <display value="BCNU Carmustine"/>
        <definition value="BCNU Carmustine"/>
      </concept>
      <concept>
        <code value="32.6"/>
        <display value="CCNU Lomustine"/>
        <definition value="CCNU Lomustine"/>
      </concept>
      <concept>
        <code value="32.7"/>
        <display value="Thoracic surgery"/>
        <definition value="Thoracic surgery"/>
      </concept>
      <concept>
        <code value="33.1"/>
        <display value="Cisplatin Any dose"/>
        <definition value="Cisplatin Any dose"/>
      </concept>
      <concept>
        <code value="33.2"/>
        <display value="Ifosfamide Any dose"/>
        <definition value="Ifosfamide Any dose"/>
      </concept>
      <concept>
        <code value="33.3"/>
        <display value="Carboplatin Any dose"/>
        <definition value="Carboplatin Any dose"/>
      </concept>
      <concept>
        <code value="34.1"/>
        <display value="RT to a volume exposing the liver"/>
        <definition value="RT to a volume exposing the liver"/>
      </concept>
      <concept>
        <code value="34.10"/>
        <display value="Chronic GVHD"/>
        <definition value="Chronic GVHD"/>
      </concept>
      <concept>
        <code value="34.11"/>
        <display value="Liver surgery"/>
        <definition value="Liver surgery"/>
      </concept>
      <concept>
        <code value="34.3"/>
        <display value="HSCT (irrespective of GVHD)"/>
        <definition value="HSCT (irrespective of GVHD)"/>
      </concept>
      <concept>
        <code value="34.5"/>
        <display value="Mercaptopurine Thioguanine"/>
        <definition value="Mercaptopurine Thioguanine"/>
      </concept>
      <concept>
        <code value="34.6"/>
        <display value="Dactinomycin"/>
        <definition value="Dactinomycin"/>
      </concept>
      <concept>
        <code value="34.8"/>
        <display value="Chronic viral hepatitis"/>
        <definition value="Chronic viral hepatitis"/>
      </concept>
      <concept>
        <code value="34.9"/>
        <display value="Sinusoidal obstruction syndrome"/>
        <definition value="Sinusoidal obstruction syndrome"/>
      </concept>
      <concept>
        <code value="35.1"/>
        <display value="HSCT (irrespective of GVHD)"/>
        <definition value="HSCT (irrespective of GVHD)"/>
      </concept>
      <concept>
        <code value="35.2"/>
        <display value="Multiple red blood cell transfusions"/>
        <definition value="Multiple red blood cell transfusions"/>
      </concept>
      <concept>
        <code value="36.1"/>
        <display value="Splenectomy"/>
        <definition value="Splenectomy"/>
      </concept>
      <concept>
        <code value="36.2"/>
        <display value="RT &gt;= 10 Gy to a vol exposing the spleen"/>
        <definition value="RT &gt;= 10 Gy to a vol exposing the spleen"/>
      </concept>
      <concept>
        <code value="36.3"/>
        <display value="Allogenic HSCT (with or without TBI)"/>
        <definition value="Allogenic HSCT (with or without TBI)"/>
      </concept>
      <concept>
        <code value="36.4"/>
        <display value="Autologus HSCT conditioned with TBI"/>
        <definition value="Autologus HSCT conditioned with TBI"/>
      </concept>
      <concept>
        <code value="37.1"/>
        <display value="Hereditary cancer sd"/>
        <definition value="Hereditary cancer sd"/>
      </concept>
      <concept>
        <code value="38.1"/>
        <display value="Any RT including TBI (predominantly in the RT field)"/>
        <definition value="Any RT including TBI (predominantly in the RT field)"/>
      </concept>
      <concept>
        <code value="38.2"/>
        <display value="HSCT Especially with a history of skin GvHD"/>
        <definition value="HSCT Especially with a history of skin GvHD"/>
      </concept>
      <concept>
        <code value="39.1"/>
        <display value="RT to a vol exposing the colon and rectum"/>
        <definition value="RT to a vol exposing the colon and rectum"/>
      </concept>
      <concept>
        <code value="40.1"/>
        <display value="RT to a vol exposing the oral cavity"/>
        <definition value="RT to a vol exposing the oral cavity"/>
      </concept>
      <concept>
        <code value="41.2"/>
        <display value="Anthracyclines and/or Mitoxantrone"/>
        <definition value="Anthracyclines and/or Mitoxantrone"/>
      </concept>
      <concept>
        <code value="41.3"/>
        <display value="Epipodophyllotoxins or autologous"/>
        <definition value="Epipodophyllotoxins or autologous"/>
      </concept>
      <concept>
        <code value="41.4"/>
        <display value="Autologous haematopoietic stem cell transplant"/>
        <definition value="Autologous haematopoietic stem cell transplant"/>
      </concept>
      <concept>
        <code value="42.1"/>
        <display
                 value="Ciclofosfamide, Ifosfamide (particularly if they have a history of severe hemorrhagic cystitis)"/>
        <definition
                    value="Ciclofosfamide, Ifosfamide (particularly if they have a history of severe hemorrhagic cystitis)"/>
      </concept>
      <concept>
        <code value="45.1"/>
        <display value="RT to a vol exposing the head or brain"/>
        <definition value="RT to a vol exposing the head or brain"/>
      </concept>
      <concept>
        <code value="46.1"/>
        <display value="RT between 15 and 35 Gy to a vol exposing the heart"/>
        <definition value="RT between 15 and 35 Gy to a vol exposing the heart"/>
      </concept>
      <concept>
        <code value="46.2"/>
        <display
                 value="Anthracyclines (doxorubicin isotoxic equivalents) between 100 and 250 mg/m2"/>
        <definition
                    value="Anthracyclines (doxorubicin isotoxic equivalents) between 100 and 250 mg/m2"/>
      </concept>
      <concept>
        <code value="47.1"/>
        <display value="RT to a vol exposing the kidney or urinary tract"/>
        <definition value="RT to a vol exposing the kidney or urinary tract"/>
      </concept>
    </CodeSystem>