IARC 60th Anniversary - 19-21 May 2026
Session : 21/05/26 - Posters
Coding the oral potentially malignant disorders trajectory: aligning WHO OPMD with ICD-10/11 and SNOMED for risk prediction and prevention policy
CAPONIO V. 1, MUSELLA G. 1, LÓPEZ-PINTOR MUÑOZ R. 6, KAUR G. 7, SAPKOTA D. 9, SOLUK TEKKESIN M. 8, COSTEA D. 5, BOSSI P. 11, ŠPILJAK B. 12, POPOSKI B. 10, BENAISSA M. 3, VARGAS P. 14, KHURRAM S. 2, SAINTIGNY P. 3, KOLJENOVIC S. 4, AMARAL MENDES R. 7, (CA21140) o. 13
1 Applied Research and Advanced Dental Education Center, University of Foggia, Foggia, Italy; 2 School of Clinical Dentistry, Faculty of Health, University of Sheffield, Sheffield, United Kingdom; 3 Univ Lyon, Université Claude Bernard Lyon 1, Inserm 1052, Cnrs 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, Lyon, France; 4 Department of Pathology, Antwerp University Hospital/ University of Antwerp, Antwerp, Belgium; 5 Centre for Cancer Biomarkers CCBio and Gade Laboratory for Pathology, Department of Clinical Medicine, Faculty of Medicine, Bergen, Norway; 6 ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain; 7 Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal; 8 University of Ankara, Ankara, Turkey; 9 Institute of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway; 10 Department of Oral and Periodontal Diseases, Faculty of Dentistry, Ss. Cyril and Methodius University in Skopje, Skopje, Macedonia; 11 IRCCS Humanitas Research Hospital, Milan, Italy; 12 Department of Oral Medicine, University of Zagreb School of Dental Medicine, Zagreb, Croatia; 13 INTERCEPTOR network (CA21140), Europe, France; 14 Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
Background
Oral potentially malignant disorders (OPMD) represent a heterogeneous group of conditions associated with an increased risk of oral squamous cell carcinoma. Standardized terminology and disease classification are essential for clinical management, epidemiological surveillance, research comparability, and health policy decision-making, particularly if multi-centre studies are to be conducted, thus enabling consistent longitudinal capture of OPMD trajectories. Despite the 2021 WHO consensus on OPMD and the transition from ICD-10 to ICD-11, discrepancies in terminology and coding persist, including limited capacity to encode histopathology-informed states such as graded oral epithelial dysplasia (OED).
Objectives
This study aimed to systematically assess the alignment between the WHO 2021 OPMD terminology and their corresponding classifications within ICD-10 and ICD-11, and the representation of key histopathology-informed states in SNOMED CT (including graded OED), and to identify inconsistencies with potential implications for clinical practice, research, trajectory modelling in multi-centre settings, and health policy.
Methods
A comparative mapping analysis was performed between OPMDs listed in the 2021 WHO consensus report and their corresponding entries in ICD-10 and ICD-11. In parallel, SNOMED CT concepts were reviewed to assess whether histopathology-informed states relevant to OPMD trajectories—particularly graded OED—can be represented and linked to clinical entities. Each disorder was evaluated for presence, hierarchical placement, specificity, and availability of dedicated codes. For OED, this specifically included whether dysplasia can be represented as a distinct state and whether grading/severity can be captured in a standardised way. Discrepancies, missing entities, and non-specific or proxy codes were identified and categorized.
Results
Significant inconsistencies were identified across the classification systems. Several OPMD entities lacked specific codes in ICD-10 and/or ICD-11, were classified under non-oral or non-premalignant categories, or were grouped within broad, non-specific diagnostic codes. Certain entities recognized by WHO, such as oral epithelial dysplasia and proliferative verrucous leukoplakia, were inadequately represented or absent. Moreover, when OED is recorded using ICD-based frameworks, grading/severity is not consistently representable, whereas SNOMED CT can encode graded dysplasia. This mismatch reduces comparability of risk-relevant states across centres.
Conclusions / Implications
Misalignment between WHO OPMD terminology and ICD coding systems compromises standardised, longitudinal capture of OPMD states and transitions, fragmenting disease trajectories and limiting comparability across sites. This directly constrains federated, multi-centre data collection and analytics, which should be regarded as a prerequisite for robust risk stratification and generalisable models of malignant transformation. Harmonisation across classification frameworks is therefore needed to enable interoperable trajectory-aware datasets that can be translated into surveillance indicators and, ultimately, evidence-informed prevention policy.
Funded by INTERCEPTOR COST Action CA21140