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

## CodeSystem: Risk Factors

Official URL: http://hl7.eu/fhir/ig/pcsp/CodeSystem/cs-riskfactor-eu-pcsp | Version: 1.0.0
Active as of 2025-10-16 | Computable Name: CsRiskFactorPcsp

Risk Factors used by the PCSP algorithm

This Code system is referenced in the content logical definition of the following value sets:

- RiskFactor

This case-sensitive code system `http://hl7.eu/fhir/ig/pcsp/CodeSystem/cs-riskfactor-eu-pcsp` defines the following codes:

Code | Display | Definition
1.1 | RT to a vol exposing the thyroid gland | RT to a vol exposing the thyroid gland
1.2 | TBI | TBI
1.3 | MIBG therapy (I-131 MIBG therapy) | MIBG therapy (I-131 MIBG therapy)
2.1 | RT >= 10 Gy to a vol exposing the breasts | RT >= 10 Gy to a vol exposing the breasts
2.2 | OR upper abdominal field radiation that can extend above the diaphragm likely exposing breast tissue at a young age | OR upper abdominal field radiation that can extend above the diaphragm likely exposing breast tissue at a young age
3.1 | RT >= 35 Gy to a vol exposing the heart | RT >= 35 Gy to a vol exposing the heart
3.2 | Anthracyclines (doxorubicin isotoxic equivalents)>= 250 mg/m2 | Anthracyclines (doxorubicin isotoxic equivalents)>= 250 mg/m2
3.3 | RT >= 15 Gy to a vol exposing the heart AND Anthracyclines (doxorubicin isotoxic equivalents)>= 100 mg/m2 | RT >= 15 Gy to a vol exposing the heart AND Anthracyclines (doxorubicin isotoxic equivalents)>= 100 mg/m2
4.1 | Alkylating agents | Alkylating agents
4.2 | RT to a vol exposing the testes | RT to a vol exposing the testes
4.3 | Including TBI | Including TBI
5.1 | RT >=12 Gy to a vol exposing the testicles | RT >=12 Gy to a vol exposing the testicles
6.3 | Surgery to the spinal cord, sympathetic nerves or pelvis | Surgery to the spinal cord, sympathetic nerves or pelvis
6.4 | Hypogonadal | Hypogonadal
7.2 | RT to a vol exposing the ovaries | RT to a vol exposing the ovaries
8.1 | RT >= 30 Gy to a vol exposing the head or the brain | RT >= 30 Gy to a vol exposing the head or the brain
8.2 | Cisplatin (with or without carboplatin > 1500 mg/m2) | Cisplatin (with or without carboplatin > 1500 mg/m2)
9.1 | RT to a vol exposing the pancreas | RT to a vol exposing the pancreas
10.2 | HSCT | HSCT
11.1 | RT to a volume exposing the hypothalamus or pituatary gland | RT to a volume exposing the hypothalamus or pituatary gland
11.3 | Hypothalamic or pituitary tumour | Hypothalamic or pituitary tumour
11.4 | Neurosurgery of the hypothalamus or pituitary gland | Neurosurgery of the hypothalamus or pituitary gland
12.1 | RT to a vol exposing the kidneys, heart and associated large vessels | RT to a vol exposing the kidneys, heart and associated large vessels
12.3 | Nephrectomy | Nephrectomy
12.4 | Ifosfamide | Ifosfamide
12.5 | Platinium based chemotherapy | Platinium based chemotherapy
12.6 | Nitrosureas | Nitrosureas
12.7 | Immunosuppressives treatment and prolonged steroids as anticancer treatment (at least 4 weeks, continuously) | Immunosuppressives treatment and prolonged steroids as anticancer treatment (at least 4 weeks, continuously)
13.1 | Cranial and/or spinal RT | Cranial and/or spinal RT
13.3 | Methotrexate | Methotrexate
13.4 | Gonadal failure | Gonadal failure
13.5 | Growth hormone deficiency | Growth hormone deficiency
13.6 | Prolonged (at least 4 weeks, continuously) corticosteroids as anti-cancer treatment | Prolonged (at least 4 weeks, continuously) corticosteroids as anti-cancer treatment
13.7 | HSCT, especially with an history of GVHD | HSCT, especially with an history of GVHD
14.3 | High dose RT | High dose RT
15.1 | Radiotherapy to a vol exposing the HP region >= 30 Gy | Radiotherapy to a vol exposing the HP region >= 30 Gy
15.2 | Surgery near or within the HP region | Surgery near or within the HP region
15.3 | CNS tumours near or within the HP region | CNS tumours near or within the HP region
16.1 | Radiotherapy to a vol exposing the HP region< 30 Gy | Radiotherapy to a vol exposing the HP region< 30 Gy
16.2 | Hydrocephalus or cerebrospinal fluid shunt(Risk factor for GHD) | Hydrocephalus or cerebrospinal fluid shunt(Risk factor for GHD)
17.1 | Radiotherapy to a vol exposing the HP region | Radiotherapy to a vol exposing the HP region
17.5 | hydrocephalus or cerebrospinal fluid shunt | hydrocephalus or cerebrospinal fluid shunt
19.3 | Radioiodine therapy (I-131 ablation therapy) | Radioiodine therapy (I-131 ablation therapy)
19.5 | Allogenic HSCT | Allogenic HSCT
19.6 | Total thyroidectomy | Total thyroidectomy
20.1 | RT to a vol exposing the head, brain or neck | RT to a vol exposing the head, brain or neck
21.1 | History of a central nervous system tumor | History of a central nervous system tumor
21.2 | RT to a vol exposing the brain ANY DOSE | RT to a vol exposing the brain ANY DOSE
21.4 | Brain surgery | Brain surgery
21.5 | High dose cytarabine IV (intravenous) | High dose cytarabine IV (intravenous)
21.6 | High dose MTX IV | High dose MTX IV
21.7 | Any Chemotherapy IT (intrathecal) | Any Chemotherapy IT (intrathecal)
22.1 | Vinca-Alkaloids | Vinca-Alkaloids
22.2 | Cisplatin or carboplatin | Cisplatin or carboplatin
23.1 | RT to a vol exposing the lens | RT to a vol exposing the lens
24.1 | RT to a vol exposing the eye and orbit | RT to a vol exposing the eye and orbit
25.1 | RT to a vol exposing the craniofacial area, especially after high doses and at a young age | RT to a vol exposing the craniofacial area, especially after high doses and at a young age
25.3 | Surgery to the face, especially at a young age | Surgery to the face, especially at a young age
26.1 | Surgery of the spine | Surgery of the spine
26.2 | Surgery of the chest (Does not include CVC pose) | Surgery of the chest (Does not include CVC pose)
26.3 | RT to a vol exposing the spine | RT to a vol exposing the spine
26.4 | Spinal or paraspinal malignancies | Spinal or paraspinal malignancies
27.1 | Cyclophosphamide | Cyclophosphamide
27.3 | RT to a vol exposing the bladder | RT to a vol exposing the bladder
27.5 | Cystectomy | Cystectomy
27.6 | Hysterectomy | Hysterectomy
27.7 | Pelvic surgery | Pelvic surgery
27.8 | Spinal cord surgery | Spinal cord surgery
28.1 | RT to a vol exposing the uterus only female | RT to a vol exposing the uterus only female
29.1 | RT to a vol exposing the oral cavity or salivary glands | RT to a vol exposing the oral cavity or salivary glands
29.4 | Chemotherapy | Chemotherapy
30.1 | RT to a vol exposing the gastro-intestinal tract | RT to a vol exposing the gastro-intestinal tract
30.3 | Oesophageal surgery | Oesophageal surgery
30.4 | Abdominal surgery | Abdominal surgery
30.5 | With a history of chronic GVHD | With a history of chronic GVHD
31.1 | Anthracyclines (doxorubicin isotoxic equivalents) <100 mg/m2 | Anthracyclines (doxorubicin isotoxic equivalents) <100 mg/m2
32.1 | RT to a vol exposing the lungs | RT to a vol exposing the lungs
32.3 | Bleomycin | Bleomycin
32.4 | Busulfan | Busulfan
32.5 | BCNU Carmustine | BCNU Carmustine
32.6 | CCNU Lomustine | CCNU Lomustine
32.7 | Thoracic surgery | Thoracic surgery
33.1 | Cisplatin Any dose | Cisplatin Any dose
33.2 | Ifosfamide Any dose | Ifosfamide Any dose
33.3 | Carboplatin Any dose | Carboplatin Any dose
34.1 | RT to a volume exposing the liver | RT to a volume exposing the liver
34.10 | Chronic GVHD | Chronic GVHD
34.11 | Liver surgery | Liver surgery
34.3 | HSCT (irrespective of GVHD) | HSCT (irrespective of GVHD)
34.5 | Mercaptopurine Thioguanine | Mercaptopurine Thioguanine
34.6 | Dactinomycin | Dactinomycin
34.8 | Chronic viral hepatitis | Chronic viral hepatitis
34.9 | Sinusoidal obstruction syndrome | Sinusoidal obstruction syndrome
35.1 | HSCT (irrespective of GVHD) | HSCT (irrespective of GVHD)
35.2 | Multiple red blood cell transfusions | Multiple red blood cell transfusions
36.1 | Splenectomy | Splenectomy
36.2 | RT >= 10 Gy to a vol exposing the spleen | RT >= 10 Gy to a vol exposing the spleen
36.3 | Allogenic HSCT (with or without TBI) | Allogenic HSCT (with or without TBI)
36.4 | Autologus HSCT conditioned with TBI | Autologus HSCT conditioned with TBI
37.1 | Hereditary cancer sd | Hereditary cancer sd
38.1 | Any RT including TBI (predominantly in the RT field) | Any RT including TBI (predominantly in the RT field)
38.2 | HSCT Especially with a history of skin GvHD | HSCT Especially with a history of skin GvHD
39.1 | RT to a vol exposing the colon and rectum | RT to a vol exposing the colon and rectum
40.1 | RT to a vol exposing the oral cavity | RT to a vol exposing the oral cavity
41.2 | Anthracyclines and/or Mitoxantrone | Anthracyclines and/or Mitoxantrone
41.3 | Epipodophyllotoxins or autologous | Epipodophyllotoxins or autologous
41.4 | Autologous haematopoietic stem cell transplant | Autologous haematopoietic stem cell transplant
42.1 | Ciclofosfamide, Ifosfamide (particularly if they have a history of severe hemorrhagic cystitis) | Ciclofosfamide, Ifosfamide (particularly if they have a history of severe hemorrhagic cystitis)
45.1 | RT to a vol exposing the head or brain | RT to a vol exposing the head or brain
46.1 | RT between 15 and 35 Gy to a vol exposing the heart | RT between 15 and 35 Gy to a vol exposing the heart
46.2 | Anthracyclines (doxorubicin isotoxic equivalents) between 100 and 250 mg/m2 | Anthracyclines (doxorubicin isotoxic equivalents) between 100 and 250 mg/m2
47.1 | RT to a vol exposing the kidney or urinary tract | RT to a vol exposing the kidney or urinary tract