Rikitake Ryoko, Yatabe Yasushi, Yamamoto Yoko, Shimoi Tatsunori, Iwata Shintaro, Goto Yasushi, Mizushima Yu, Kawai Akira, Higashi Takahiro
Division of Health Services Research, Institute for Cancer Control, National Cancer Center, Tokyo, Japan.
Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan.
Pathol Int. 2025 Jun;75(6):291-309. doi: 10.1111/pin.70021. Epub 2025 May 16.
Several classifications have been proposed to define rare cancers; however, the pathophysiological understanding of tumors evolves rapidly. We propose a New Classification of Rare Cancer (NCRC) using the updated International Classification of Diseases for Oncology 3.2 coding system and World Health Organization Classification of Tumors 5th edition. We applied patient data recorded in the National Cancer Registry of Japan to the new classification, setting a cut-off of a crude incidence rate of 6 cases/100 000/year to define rare cancers, and developed a list of rare cancers in Japan from 2016 to 2019. The NCRC system identified various rare cancers, comprising 20.0% of all cancer diagnoses in this period. To examine this classification system's performance, we compared rare/non-rare labeling of cancers by the Surveillance of Rare Cancers in Europe (RARECARENet) project and NCRC system. Compared with cases using the RARECARENet classification in Europe, 69 351 cases/year (6.8%) switched status with our classification, with 45 293 and 232 109 cases (4 years) switching from rare and non-rare, respectively. Major differences included diffuse large B-cell lymphomas, some thyroid cancers, oral cavity and lip cancers, and squamous cell carcinoma of the uterine cervix. As the NCRC includes newly classified tumor entities, it warrants validation using other diverse cohorts.
已经提出了几种分类方法来定义罕见癌症;然而,对肿瘤的病理生理学理解正在迅速发展。我们使用更新后的国际肿瘤疾病分类3.2编码系统和世界卫生组织肿瘤分类第5版,提出了一种罕见癌症新分类(NCRC)。我们将日本国家癌症登记处记录的患者数据应用于新分类,设定每年每10万人中6例的粗发病率作为定义罕见癌症的临界值,并编制了2016年至2019年日本罕见癌症清单。NCRC系统识别出了各种罕见癌症,占这一时期所有癌症诊断的20.0%。为了检验这个分类系统的性能,我们比较了欧洲罕见癌症监测(RARECARENet)项目和NCRC系统对癌症的罕见/非罕见分类。与欧洲使用RARECARENet分类的病例相比,每年有69351例(6.8%)病例在我们的分类中改变了状态,其中分别有45293例和232109例(4年)从罕见变为非罕见,以及从非罕见变为罕见。主要差异包括弥漫性大B细胞淋巴瘤、一些甲状腺癌、口腔和唇癌以及子宫颈鳞状细胞癌。由于NCRC包括新分类的肿瘤实体,因此需要使用其他不同队列进行验证。