Cancer and conditions predisposing to cancer
Advice on health categories
In studies of cancer, only the Cancer category should be used – do not code for the site. This is in line with the coding guidance to assign health categories based on the main disease and not pathogenesis or site of action. However if the research involves studying a condition that predisposes to cancer, it may be appropriate to also code for the condition.
e.g. studies of Barrett’s oesophagus in relation to cancer would be 50% Oral and Gastrointestinal and 50% Cancer.
e.g. studies of pathogens and their association with the development of cancer, such as Human Papilloma Virus (HPV) or Helicobacter pylori, should be coded 50% Infection and 50% Cancer.
Studies of the normal role of oncogenes and tumour suppressor genes in a non diseased cell may be coded as 50% Generic Health Relevance and 50% Cancer.
Advice on research activities
Cancer is not a ‘normal’ process and hence studies that specifically relate to the cause of cancer are rarely coded within the 1 Underpinning code group.
In particular studies of abnormal cell cycle or DNA repair in relation to cancer should not be coded within the 1 Underpinning code group.
Studies of the normal role of oncogenes and tumour suppressor genes in a non diseased cell should be coded as 50% 1.1 Biological and 50% 2.1 Endogenous risks.
Main inclusion criteria
Identification and characterisation of endogenous factors known or suspected to be involved in the cause, risk or development of disease, conditions or ill health including
- genes and gene products, molecular, cellular and physiological structures and functions
- biological factors linked to ethnicity, age, gender, pregnancy and body weight
- endogenous biological factors or pathways involved in responses to infection or damage by external factors
- metastases, degenerative processes, regeneration and repair
- complications, reoccurrence and secondary conditions
- bioinformatics and structural studies
- development and characterisation of models
Advice on research activities
To be used to code all biological causes of disease including the following
- Host cell biological responses to infection
- prion/TSE aetiological studies
- ischemic preconditioning
Characterisation of pathways to identify candidates that may potentially be used as diagnostic markers should be coded as 2.1 Endogenous risks and not 4.1 Marker discovery.
Characterisation of the biological cause of psychological conditions should be coded as 2.1. However 2.3 Psychological risks can also be used if the study includes investigation of symptoms and characteristics of the psychological condition.
Awards that are focused on therapeutic development or diagnostics will often yield information about the mechanism of a disease. However, this is generally a secondary outcome and shouldn’t be coded 2.1 unless this is clearly stated as one of the primary objective of the research.
Excludes basic immune and pain responses and wound healing studies that are not linked to a specific disease/condition stimulus and normal ageing or pregnancy not linked to a condition which should be coded as 1.1 Biological normal function.
Excludes normal cell cycle and normal DNA repair and replication which should be coded as 1.1 Biological.
Official terminology
|
Full name of code |
Short name | Unique ID |
| 2.1 Biological and endogenous factors | 2.1 Endogenous risks |
HRCS_RA_2_1 |
Related external links
Common Scientific Outline (CSO) – 1.2 Cancer Initiation: Alterations in Chromosomes
Common Scientific Outline (CSO) – 1.3 Cancer Initiation: Oncogenes and Tumour Suppressor Genes
Common Scientific Outline (CSO) – 1.4 Cancer Progression and Metastasis
Common Scientific Outline (CSO) – 2.2 Endogenous Factors in the origin and cause of cancer
Common Scientific Outline (CSO) – 2.3 Interactions of Genes and/or Genetic Polymorphisms with Exogenous and/or Endogenous Factors
Main inclusion criteria
- Research applicable to all diseases and conditions or to general health and well-being of individuals.
- Public health research, epidemiology and health services research that is not focused on specific conditions.
- Underpinning biological, psychosocial, economic or methodological studies that are not specific to individual diseases or conditions.
Advice on health categories
There are four main circumstances where the Generic Health Relevance category is most applicable:
- Research that is relevant to all diseases and conditions or to general health and well-being.
- For example, many studies with research activity coded as 1 Underpinning involves study of normal processes that may be relevant to all diseases and conditions e.g. cell cycle or DNA repair, developmental biology.
- Any research that cannot be attributed to a particular disease or condition or to normal function of a specific type of cell or system, defined by the top 19 health categories.
- e.g. Studies of wounds and healing without a specified tissue type or specifically caused by Accident or Injuries.
- If research is judged relevant to more than five Health Categories then these should be substituted for 100% Generic Health Relevance.
- As an additional code for studies with a disease(s)/condition(s) of focus which also has relevance to many other diseases/conditions.
- This final circumstance has considerable scope, so additional guidance is given below.
Generic Health Relevance as an additional code
If the main focus of the research is directed at several specified diseases and also has implications for many other conditions, the appropriate specific Health Categories should be used as well as applying the Generic category. (Note that this does not apply to diseases that may be listed within the background information or are noted as ‘being relevant’ to the study under investigation; many awards will reference multiple conditions to provide a context for the research, but always apply coding based on the lifetime of the award – (see the coding guidance on assigning health categories.)
Examples of this use of Generic Health Relevance coding appears across the HRCS guidance, including:
- Cancer studies – Studies of the normal role of oncogenes and tumour suppressor genes in a non-diseased cell may be coded as 50% Cancer and neoplasms and 50% Generic.
- Pollution – If there is no other indication of the health effects of air pollution, code 50% Respiratory for the direct effects on the lungs and 50% Generic for other effects.
- Environmental radiation – Studies of the effects of environmental radiation exposure should be coded 33.33% Cancer, 33.33% Congenital Disorders and 33.33% Generic.
- Studies where a particular condition is used as an exemplar or case study to evaluate models, services and systems may also be coded as Generic – see Case studies, exemplars and tracer conditions guidance for more details.
Official terminology
|
Full name of category |
Short name | Unique ID |
| Generic health relevance | Generic |
HRCS_HC_20GEN |
Related external links
None.
Main inclusion criteria
Inflammatory bowel disease, Crohn’s disease, diseases of the mouth, teeth, oesophagus, digestive system including liver and colon, and normal oral and gastrointestinal development and function.
Advice on health categories
Includes dental research and studies on the mouth, throat, stomach, liver, pancreas (not diabetes/insulin related), gut and colon.
Also suitable for problems linked to food absorption by the gut.
Official terminology
|
Full name of category |
Short Name | Unique ID |
| Oral and gastrointestinal | Oral |
HRCS_HC_14ORA |
Related external links
Main inclusion criteria
Studies of normal biology including:
- genes and gene products
- molecular, cellular and physiological structures and function
- biological pathways and processes including normal immune function
- developmental studies and normal ageing
- bioinformatics and structural studies
- development and characterisation of model systems
Advice on research activities
To be used for research involving normal biological function including the following:
- basic immune and pain responses and wound healing studies that are not linked to a specific disease/condition stimulus
- normal ageing or pregnancy not linked to a condition
- normal stem cell research into differentiation and basic developmental biology of stem cells not linked to therapeutic development
- protein structural studies
- bioinformatics
- normal cell cycle and DNA replication and repair
Excludes studies characterising proteins or pathways linked to a condition or disease.
Excludes studies of processes associated to cancer which are rarely ‘normal’.
Official terminology
|
Full name of code |
Short name | Unique ID |
| 1.1 Normal biological development and functioning | 1.1 Biological |
HRCS_RA_1_1 |
Related external links
Common Scientific Outline (CSO) – 1.1 Normal Functioning
Main inclusion criteria
Research that underpins investigations into the cause, development, detection, treatment and management of diseases, conditions and ill health.
Advice on research activities
This code group is for all types of research into ‘normal’ functions and processes in ‘healthy’ humans or systems.
Excludes research where the main aims relate to investigation of the cause, development, prevention, detection, treatment or management of a disease or condition.
Official terminology
|
Full name of code |
Short name | Unique ID |
| 1 Underpinning research | 1 Underpinning |
HRCS_RAG_1 |
Related external links
Common Scientific Outline (CSO) – 1 Biology
Summary of Underpinning sub-codes
1.1 Normal biological development and functioning
Studies of normal biology including:
- genes and gene products
- molecular, cellular and physiological structures and function
- biological pathways and processes including normal immune function
- developmental studies and normal ageing
- bioinformatics and structural studies
- development and characterisation of model systems
1.2 Psychological and socioeconomic process
Studies that do not address health directly but cover issues that may have a bearing on health and well-being including:
- perception, cognition and learning processes
- social and cultural beliefs
- individual or group characteristics and behaviours
- politics, economies and urban development
- development and characterisation of model systems
1.3 Chemical and physical sciences
Research in chemical and physical sciences that may lead to the future development of diagnostic tools or medical treatments including:
- bioengineering and biophysics
- chemical structures, interactions and properties
- molecular modelling
- material science
1.4 Methodologies and measurements
Development of novel underpinning research measures and analytical methodologies including:
- development of statistical methods and algorithms for genomic analysis
- development of mapping methodologies and novel data comparison methods
- development of biological, psychological and socioeconomic research measures
1.5 Resources and infrastructure (underpinning)
Development and/or distribution of resources for use by the research community including:
- equipment, cell lines, DNA banks, and genomic and proteomic sequence resources
- infrastructure to support research networks, consortia and centres
Main inclusion criteria
Diseases caused by pathogens, acquired immune deficiency syndrome, sexually transmitted infections and studies of infection and infectious agents.
Advice on health categories
Infection should be used for all research on pathogens and diseases caused by infection. These studies should be coded as 100% Infection and should not also be coded to the target disease site.
e.g. infection by malaria parasite should be coded as 100% Infection and not Blood.
e.g. respiratory infections should be coded as 100% Infection and not Respiratory.
Studies involving acute immune response to infection should be coded as Infection. However studies of natural tolerance and immunity to infections should be coded as 100% Inflammatory and Immune System.
Excludes TSEs, CJD and prion studies which should be coded as 100% Neurological regardless of whether the study is investigating transmission or mechanism of disease.
Infections can often follow or precede other diseases or conditions. There is general guidance on sequelae and side effects of disease, but there are also several examples across the existing HRCS guidance where addition of further health categories would be recommended:
- Studies of the downstream consequences of infection may also be coded to the disease or condition under investigation.
- e.g. surgery on diseased liver from Hepatitis C infection should be coded as 50% Infection and 50% Oral and Gastrointestinal.
- Studies that involve infection of a specific target patient group should be coded as 50% Infection and 50% to the appropriate health category.
- e.g. respiratory infection in people with cystic fibrosis should be coded as 50% Infection and 50% Congenital Disorders.
- General studies on sexual health, including sexually transmitted infections (STIs), should be coded as 50% Infection and 50% Reproductive Health and Childbirth, but only if there is no named pathogen. If a pathogen is specified, use 100% Infection.
- e.g. Studies of total STI rate in teenagers should be coded as 50% Infection, 50% Reproduction.
- e.g. Studies of gonorrhea in teenagers should be coded as 100% Infection.
- Studies of cancer causing pathogens should be coded as 50% Cancer and 50% Infection.
- Sepsis should be coded as 50% Infection and 50% Inflammatory and Immune System.
Official terminology
|
Full name of category |
Short name | Unique ID |
| Infection | Infection |
HRCS_HC_07INF |
Related external links
Main inclusion criteria
All types of neoplasms, including benign, potentially malignant, malignant (cancer) and canerous growths. This includes leukaemia and mesothelioma.
Advice on health categories
Do not code to the site of the cancer. However if the research involves studying a condition that predisposes to cancer then it may be appropriate to code for this condition as well.
e.g. The role of Barrett’s oesophagus in cancer would be 50% Oral and Gastrointestinal and 50% Cancer.
Similarly research on pathogens associated with the development of cancer should be coded as 50% Cancer and 50% Infection.
Studies of the normal role of oncogenes, tumour suppressor genes, and cell cycle checkpoints in a non diseased cell should be coded as 50% Generic Health Relevance and 50% Cancer.
Excludes general studies of angiogenesis which should be coded as Cardiovascular. However the development of anti-angiogenic drugs to inhibit tumour growth would be coded as Cancer.
Excludes normal studies of cell cycle and DNA replication and repair which should be coded as Generic.
Official terminology
|
Full name of category |
Short name | Unique ID |
| Cancer | Cancer |
HRCS_HC_02CAN |
Related external links
International Classification of Diseases (ICD 10 v2016) – Chapter II: Neoplasms (C00-D48)