Diagnosis of Digestive System Tumours: the WHO Classification.

M Kay Washington, Richard M Goldberg, George J Chang, Paul Limburg, Alfred Lam, Manuel Salto-Tellez, Mark J Arends, Iris D Nagtegaal, David Klimstra, Massimo Rugge, Peter Schirmacher, Alexander J. Lazar, Robert Odze, Fátima Carneiro, A. Cree

Research output: Contribution to journalArticlepeer-review


The WHO Classification of Tumours provides the international standards for the classification and diagnosis of tumours. It enables direct comparisons to be made between different countries. In the new 5th Edition, the series has gone digital with the launch of a website as well as a series of books, known widely as the WHO Blue Books. The first volume to be produced is on the classification of Digestive System tumours, replacing the successful 2010 version. It has been rewritten and updated accordingly. This article summarises the major diagnostic innovations that have occurred over the last decade and that have now been incorporated in the classification. As an example, it incorporates the recently proposed classification of neuroendocrine tumours, based on the recognition that neuroendocrine tumours and carcinomas differ substantially in the genetic abnormalities that drive their growth, findings relevant to treatment selection and outcome prediction. Several themes have emerged during the production process. One is the importance of the progression from hyperplasia to dysplasia to carcinoma in the evolution of the malignant process. Advances in imaging techniques and endoscopy have resulted in enhanced access to precancerous lesions in the gastrointestinal and biliary tract, necessitating both changes in classification schema and clinical practice. Diagnosis of tumours is no longer the sole purview of pathologists, and some patients now receive treatment before tissue is obtained, based on clinical, radiological, and liquid biopsy results. This makes the classification relevant to many disciplines involved in the care of patients with tumours of the digestive system.
Original languageEnglish
JournalInternational Journal of Cancer
Early online date16 Jul 2020
Publication statusE-pub ahead of print - 16 Jul 2020


  • tumour
  • classification
  • diagnosis
  • Digestive system
  • neoplasms
  • neuroendocrine


Dive into the research topics of 'Diagnosis of Digestive System Tumours: the WHO Classification.'. Together they form a unique fingerprint.

Cite this