Hi all,
The next CMAG meeting is 11:00-12:00 UTC 24th June 2026. Please reply to this discussion topic with any agenda items that you’d like to bring forward or have discussed at the June CMAG meeting. These should be added to this post by Friday 19th June 2026.
To see the draft agenda, please click here.
Thank you!
Hi Sarah,
We’d like to discuss with the group the current modeling and naming policy for procedures connected to detecting HPV and/or pre-cancerous/cancerous cells in the cervical region.
Our national screening program for cervical cancer has recently updated their guidelines for testing and analyzing said tests, and currently the content in SNOMED CT that deals with these tests are defined as always being of a cytologic kind. Meanwhile, our new guidelines defer to a liquid based cell sampling from the cervix that may be used to test for the presence of HPV, and if positive, used for further (cytological) testing to look for pre-cancerous/cancerous cells.
This puts us in a bit of a pickle. The procedure to obtain cell samples is the same for both the HPV test and the cytological test, and the same test tube is used for both analyses. In the cases where the HPV testing is negative, a cytological analysis is never done. Therefore, calling a procedure a “liquid based cytology” when it won’t necessarily be analyzed for cytology seems incorrect.
We want to have a discussion around whether or not we’re the only ones in this predicament, or if we ought to raise the issue to SNOMED International for a thorough review of existing content.
Best regards,
Hanne
Norwegian NRC
Thanks Hanne. I’ve added this to the agenda. Please see the updated draft agenda here.
Best wishes, Sarah
Sorry I missed this meeting last week. Thanks for raising @hjohansen .
This hasn’t quite come up for us (yet) but it’s almost certainly an issue for us also.
We’ve got these related tests in our College Catalogue (they’ve chosen these codes)
The College (RCPA) has developed this test catalogue over almost a decade, and a number of strange patterns have emerged - where multiple codes exist for what is in practice handled the same way. We’ve agreed to review these and try and prune the catalogue (we can’t do much with the content in general). The above concepts might all be ontologically different, but from the perspective of the lab - they’re probably all treated the same (effectively synonymous in practice). I suspect after our review they’ll probably end up with just two concepts, not 6.
I’m not sure what the guidelines in Australia are for cervical screen. But what you’ve described sounds like reflex testing. Where what’s actually performed depends on the results - but the requested procedure is identical (and often silent on the specifics).
It’s also why we use the Procedure concepts for Pathology (not observables) - because they are procedures, that can have multiple (optional) steps, components, and observations.
Thanks @mcordell, we’d be interested to see what concepts you end up with after your review.
The point you make about using procedure concepts for pathology is the same approach we’re looking into. The observables are useful for laboratories and registries, but procedures describing what the clinicians have physically done to gather the specimens being analyzed (without any assumptions on how the material will be analyzed in the lab) is harder to find in SNOMED right now.
We’ve also had some feedback that calling these procedures “screening procedure” means the clinicians don’t feel like they can use them for testing patients with symptoms as the trigger for the test. In some cases the patient might not be tested as a result of a screening program but rather because the signs and symptoms indicate possible disease. Meanwhile, the procedure and equipment used for both screening tests and otherwise are exactly the same.