{{Short description|Series of books that classify tumours}} {{Infobox book series | name = WHO Blue Books | image = WHO Digestive System Tumours blue book.jpg | image_caption = Cover of the WHO blue book on ''Digestive System Tumours'', 5th edition | books =''Digestive System Tumours'' ''Breast tumours'' ''Soft tissue and bone tumours'' ''Female genital tumours '' ''Thoracic tumours '' | author = | editors = WHO Classification of Tumours Group (World Health Organization) | title_orig = | translator = | illustrator = | cover_artist = | country = France | language = | discipline = Tumours | publisher = International Agency for Research on Cancer | pub_date = | english_pub_date = | media_type = | number_of_books = | list_books = | oclc = | preceded by = International Histological Classification of Tumors | followed by = | website = }} The '''''WHO Classification of Tumours''''', more commonly known as the '''''WHO Blue Books''''', is a series of books that classify tumours. They are compiled by expert consensus and published by the World Health Organization's (WHO) International Agency for Research on Cancer (IARC). They appear in print and online in a series of 15 books, each of which focuses on a major tumour group and defines the cause, mechanism, signs and symptoms, basic structure, diagnosis, epidemiology and outcomes of up to 300 types of tumours.
The project was started by the WHO in 1956 and the first series of books was published between 1967 and 1981, as the ''International Histological Classification of Tumors'' series. A fifth series was released in 2019. Terms included in the books appear in the international classification of diseases for tumours.
The classifications are regularly updated by an editorial board composed mostly of practicing pathologists. The method of classifying tumours in the Blue Books was discussed in an accompanying article in the ''International Journal of Cancer'' in June 2020, titled "WHO Classification of Tumours: How should tumors be classified? Expert consensus, systematic reviews or both?"<ref name="Plass2020"/>
==The series== The ''WHO Classification of Tumours'' series, more commonly known as the ''WHO Blue Books'', published by the WHO's IARC, is a series of books that classify tumours according to principally its location and histopathology.<ref name="CreeFeb2020">{{cite journal |last1=Cree |first1=Ian A |last2=Indave |first2=B Iciar |title=Commentary: Cancer research quality and tumour classification |journal=Tumor Biology |date=1 February 2020 |volume=42 |issue=2 |article-number=1010428320907544 |doi=10.1177/1010428320907544 |pmid=32098581 |language=en |issn=1010-4283|doi-access=free }}</ref><ref name=Turner2019/> They are compiled by expert consensus, teams of specialists at the International Agency for Research on Cancer, who summarize information from literature.<ref name="Plass2020"/> Terms included in the books appear in the international classification of diseases for tumours.<ref name=NIH>{{cite web |title=WHO Blue Book Terms {{!}} SEER Training |url=https://training.seer.cancer.gov/icdo3/new/terms/who.html |website=training.seer.cancer.gov}}</ref><ref name="Inzanik2017">{{cite book |last1=Inzani |first1=Frediano |last2=Rindi |first2=Guido |editor1-last=Pacak |editor1-first=Karel |editor2-last=Taieb |editor2-first=David |title=Diagnostic and Therapeutic Nuclear Medicine for Neuroendocrine Tumors |date=2017 |publisher=Humana Press |isbn=978-3-319-46036-9 |page=1 |url=https://books.google.com/books?id=T5TLDQAAQBAJ |chapter=1. Classifications of neuroendocrine neoplasms}}</ref>
They are published as a series of 15 books, in addition to a website, which provide information on cancer diagnosis, research, treatment and outcomes, particularly for pathologists and cancer researchers.<ref name="Plass2020">{{cite journal |last1=Plass |first1=Christoph |title=A new series of Invited Reviews on WHO tumor classification |journal=International Journal of Cancer |date=2020 |volume=146 |issue=12 |page=3243 |doi=10.1002/ijc.32983 |pmid=32187660 |language=en |issn=1097-0215|doi-access=free }}</ref><ref name="Uttley2020"/> Each book defines the cause, mechanism, signs and symptoms, basic structure, diagnosis, epidemiology and outcomes of up to 300 types of tumours.<ref name="Uttley2020">{{cite journal |last1=Uttley |first1=Lesley |last2=Indave |first2=Blanca Iciar |last3=Hyde |first3=Chris |last4=White |first4=Valerie |last5=Lokuhetty |first5=Dilani |last6=Cree |first6=Ian |title=Invited commentary—WHO Classification of Tumours: How should tumors be classified? Expert consensus, systematic reviews or both? |journal=International Journal of Cancer |date=15 June 2020 |volume=146 |issue=12 |pages=3516–3521 |doi=10.1002/ijc.32975 |pmid=32170735 |issn=0020-7136|pmc=7818407 }}</ref> Between 150 - 200 authors, including radiologists, surgeons, physicians and epidemiologists, contribute to each book.<ref name="CreeFeb2020"/>
==Editorial board== The WHO Classification of Tumors Group is headed by Ian Cree.<ref name=Turner2019>{{cite web|last=Turner|first=Luke|date=24 July 2019|title=The Blue Books Are Back!|url=https://thepathologist.com/outside-the-lab/the-blue-books-are-back|url-status=live|archive-url=https://web.archive.org/web/20210515165207/https://thepathologist.com/outside-the-lab/the-blue-books-are-back|archive-date=15 May 2021|access-date=7 July 2021|website=The Pathologist|language=en}}</ref> The classifications are updated regularly by an editorial board composed mostly of practicing pathologists,<ref name="Uttley2020"/><ref name="Cree2020">{{cite journal |last1=Cree |first1=Ian A. |last2=White |first2=Valerie A. |last3=Indave |first3=B. Iciar |last4=Lokuhetty |first4=Dilani |title=Revising the WHO classification: female genital tract tumours |journal=Histopathology |date=2020 |volume=76 |issue=1 |pages=151–156 |doi=10.1111/his.13977 |pmid=31846528 |s2cid=209407479 |url=https://onlinelibrary.wiley.com/doi/10.1111/his.13977 |language=en |issn=1365-2559|url-access=subscription}}</ref> who review and agree on definitions and criteria for each tumor.<ref name="Uttley2020"/>
The editorial board consists of standing members and expert members. Experts are listed in each of the tumour specialties; digestive system tumours, breast tumours, soft tissue and bone tumours, female genital tumours, thoracic tumours. central nervous system tumours, paediatric tumours, urinary and male genital tumours, head and neck tumours, and endocrine and neuroendocrine tumours.<ref name="Members2021">{{cite web |title=WHO Classification of Tumours - Standing members |url=https://whobluebooks.iarc.fr/editorialboard/standingmembers/index.php |website=whobluebooks.iarc.fr |access-date=10 July 2021 |archive-url=https://web.archive.org/web/20200220225504/http://whobluebooks.iarc.fr/editorialboard/standingmembers/index.php |archive-date=20 February 2020}}</ref>
==History== The WHO started the project on the blue books in 1956.<ref name="History2021">{{cite web |title=WHO Classification of Tumours |url=https://whobluebooks.iarc.fr/about/history.php |website=whobluebooks.iarc.fr |access-date=10 July 2021 |archive-url=https://web.archive.org/web/20210710064039/https://whobluebooks.iarc.fr/about/history.php|archive-date=10 July 2021}}</ref>
===First and second series (1967-2000)=== Leslie Sobin edited the first edition, published from 1967 to 1981, as the ''International Histological Classification of Tumors'' series.<ref name="History2021"/><ref name="Kleihues">{{cite journal |last1=Kleihues |first1=Paul |last2=Sobin |first2=Leslie H. |title=World Health Organization classification of tumors |journal=Cancer |date=2000 |volume=88 |issue=12 |page=2887 |doi=10.1002/1097-0142(20000615)88:12<2887::AID-CNCR32>3.0.CO;2-F |issn=1097-0142|pmid=10870076|doi-access=free }}</ref> Sobin edited a second edition of 25 volumes, published by Springer between 1982 and 2002.<ref name="History2021"/>
In 1993 the WHO approved a concise classification of tumours affecting the central nervous system.<ref name="NICE2016">{{cite web |title=Appendix E. The new WHO Classification of Tumours affecting the Central Nervous System {{!}} Guidance on the use of temozolomide for the treatment of recurrent malignant glioma (brain cancer) {{!}} Guidance {{!}} NICE |url=https://www.nice.org.uk/guidance/ta23/chapter/appendix-e-the-new-who-classification-of-tumours-affecting-the-central-nervous-system |website=www.nice.org.uk |access-date=8 July 2021 |archive-url=https://web.archive.org/web/20210708114518/https://www.nice.org.uk/guidance/ta23/chapter/appendix-e-the-new-who-classification-of-tumours-affecting-the-central-nervous-system |archive-date=8 July 2021 |date=3 March 2016}}</ref> It was later revised in 2007 and then in 2016.<ref name="Louis2016">{{cite journal |last1=Louis |first1=David N. |last2=Perry |first2=Arie |last3=Reifenberger |first3=Guido |last4=von Deimling |first4=Andreas |last5=Figarella-Branger |first5=Dominique |last6=Cavenee |first6=Webster K. |last7=Ohgaki |first7=Hiroko |last8=Wiestler |first8=Otmar D. |last9=Kleihues |first9=Paul |last10=Ellison |first10=David W. |title=The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary |journal=Acta Neuropathologica |date=1 June 2016 |volume=131 |issue=6 |pages=803–820 |doi=10.1007/s00401-016-1545-1 |pmid=27157931 |s2cid=3345100 |language=en |issn=1432-0533|doi-access=free }}</ref>
===Third series (2000)=== The third edition of 10 volumes, was published in a new style as a series of ''World Health Organization Classification of Tumors'' from 2000 to 2005, and edited by Sobin and Paul Kleihues.<ref name="History2021"/><ref name="Kleihues"/>
===Fourth series (2006)=== In 2006, the fourth edition was initiated and guided by series editors Fred Bosman, Elaine S. Jaffe, Sunil R. Lakhani, and Hiroko Ohgaki. It was completed in 2018 and included 12 volumes plus revised versions of central nervous system tumours and blood cancers.<ref name="History2021"/>
The fourth edition of the ''WHO Classification of Digestive System Tumors'' was published in 2010.<ref name="Nagtegaal2020">{{cite journal |last1=Nagtegaal |first1=Iris D. |last2=Odze |first2=Robert D. |last3=Klimstra |first3=David |last4=Paradis |first4=Valerie |last5=Rugge |first5=Massimo |last6=Schirmacher |first6=Peter |last7=Washington |first7=Kay M. |last8=Carneiro |first8=Fatima |last9=Cree |first9=Ian A. |title=The 2019 WHO classification of tumours of the digestive system |journal=Histopathology |date=January 2020 |volume=76 |issue=2 |pages=182–188 |doi=10.1111/his.13975 |pmid=31433515 |issn=1365-2559|pmc=7003895 }}</ref> A fourth edition describing breast tumours was published in 2012,<ref name="Tan2020">{{cite journal |last1=Tan |first1=Puay Hoon |last2=Ellis |first2=Ian |last3=Allison |first3=Kimberly |last4=Brogi |first4=Edi |last5=Fox |first5=Stephen B |last6=Lakhani |first6=Sunil |last7=Lazar |first7=Alexander J |last8=Morris |first8=Elizabeth A |last9=Sahin |first9=Aysegul |last10=Salgado |first10=Roberto |last11=Sapino |first11=Anna |last12=Sasano |first12=Hironobu |last13=Schnitt |first13=Stuart |last14=Sotiriou |first14=Christos |last15=Diest |first15=Paul |last16=White |first16=Valerie A |last17=Lokuhetty |first17=Dilani |last18=Cree |first18=Ian A |title=The 2019 World Health Organization classification of tumours of the breast |journal=Histopathology |date=August 2020 |volume=77 |issue=2 |pages=181–185 |doi=10.1111/his.14091 |pmid=32056259 |url=https://onlinelibrary.wiley.com/doi/10.1111/his.14091 |language=en |issn=0309-0167|hdl=11343/252349 |s2cid=211111446 |hdl-access=free }}</ref> ''Tumours of the Central Nervous System'' in 2017,<ref name="Katabi2017">{{cite journal |last1=Katabi |first1=Nora |last2=Lewis |first2=James S. |title=Update from the 4th Edition of the World Health Organization Classification of Head and Neck Tumours: What Is New in the 2017 WHO Blue Book for Tumors and Tumor-Like Lesions of the Neck and Lymph Nodes |journal=Head and Neck Pathology |date=March 2017 |volume=11 |issue=1 |pages=48–54 |doi=10.1007/s12105-017-0796-z |pmid=28247228 |issn=1936-0568|pmc=5340737 }}</ref> and the ''WHO Classification of Skin Tumors'' in 2018.<ref name="Garbe2020">{{cite journal |last1=Garbe |first1=Claus |last2=Amaral |first2=Teresa |last3=Peris |first3=Ketty |last4=Hauschild |first4=Axel |last5=Arenberger |first5=Petr |last6=Bastholt |first6=Lars |last7=Bataille |first7=Veronique |last8=Marmol |first8=Veronique del |last9=Dréno |first9=Brigitte |last10=Fargnoli |first10=Maria Concetta |last11=Grob |first11=Jean-Jacques |last12=Höller |first12=Christoph |last13=Kaufmann |first13=Roland |last14=Lallas |first14=Aimilios |last15=Lebbé |first15=Celeste |last16=Malvehy |first16=Josep |last17=Middleton |first17=Mark |last18=Moreno-Ramirez |first18=David |last19=Pellacani |first19=Giovanni |last20=Saiag |first20=Philippe |last21=Stratigos |first21=Alexander J. |last22=Vieira |first22=Ricardo |last23=Zalaudek |first23=Iris |last24=Eggermont |first24=Alexander M. M. |title=European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics – Update 2019 |journal=European Journal of Cancer |date=1 February 2020 |volume=126 |pages=141–158 |doi=10.1016/j.ejca.2019.11.014 |pmid=31928887 |url=https://www.ejcancer.com/article/S0959-8049(19)30833-0/fulltext |language=English |issn=0959-8049|doi-access=free |hdl=11368/2958962 |hdl-access=free }}</ref> In it, the classification of melanoma is based on its mechanism and its association with sun-exposed skin.<ref name="Garbe2020"/>
*{{cite book |title=WHO classification of Tumours of the Central Nervous System |location=Lyon (France) |date=2016 |publisher=International Agency for Research on Cancer |isbn=978-92-832-4492-9 |url=https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/WHO-Classification-Of-Tumours-Of-The-Central-Nervous-System-2016|volume=1|edition=4th|language=English}} *{{cite book |title=WHO Classification of Tumours of Endocrine Organs |location=Lyon (France) |date=2017 |volume=10|isbn=978-92-832-4493-6 |edition=4|url=https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/WHO-Classification-Of-Tumours-Of-Endocrine-Organs-2017|publisher=International Agency for Research on Cancer |language=English}} *{{cite book|title=WHO Classification of Skin Tumours|publisher=International Agency for Research on Cancer|year=2018|isbn=978-92-832-2440-2|edition=4th|url=https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/WHO-Classification-Of-Skin-Tumours-2018|volume=11|location=Lyon (France)|language=en}}
===Fifth series (2019)=== A fifth series was released in 2019, in a lighter blue and with a bold "5" on the book spine, to make it distinct from older outdated editions that might inadvertently be referred to.<ref name=Turner2019/> The text appears in two columns; previously there were three.<ref name=Turner2019/> It is the first in the series of the WHO blue books to appear online in its complete form, and includes a few books from the fourth series with the aim of updating books as they develop.<ref name=Turner2019/> Its website uses images and hyperlinks.<ref name="Cree2020"/>
The first volume to be produced was on the classification of ''Digestive System Tumours''.<ref name="Washington2021">{{cite journal |last1=Washington |first1=Mary Kay |last2=Goldberg |first2=Richard M. |last3=Chang |first3=George J. |last4=Limburg |first4=Paul |last5=Lam |first5=Alfred K. |last6=Salto-Tellez |first6=Manuel |last7=Arends |first7=Mark J. |last8=Nagtegaal |first8=Iris D. |last9=Klimstra |first9=David S. |last10=Rugge |first10=Massimo |last11=Schirmacher |first11=Peter |last12=Lazar |first12=Alexander J. |last13=Odze |first13=Robert D. |last14=Carneiro |first14=Fatima |last15=Fukayama |first15=Masashi |last16=Cree |first16=Ian A. |title=Diagnosis of digestive system tumours |journal=International Journal of Cancer |date=1 March 2021 |volume=148 |issue=5 |pages=1040–1050 |doi=10.1002/ijc.33210 |pmid=32674220 |issn=1097-0215|hdl=20.500.11820/cde19704-b358-45fd-89cc-aae542d82305 |s2cid=220608072 |hdl-access=free }}</ref> Seven years after the fourth edition, a fifth edition on ''Soft Tissue and Bone Tumours'' was published in May 2020.<ref name="Choi2020">{{cite journal |last1=Choi |first1=Joon Hyuk |last2=Ro |first2=Jae Y. |title=The 2020 WHO Classification of Tumors of Bone: An Updated Review |journal=Advances in Anatomic Pathology |date=1 May 2021 |volume=28 |issue=3 |pages=119–138 |doi=10.1097/PAP.0000000000000293 |pmid=33480599 |s2cid=231679037 |issn=1533-4031}}</ref><ref name="Anderson2021">{{cite journal|last1=Anderson|first1=William J.|last2=Doyle|first2=Leona A.|date=2021|title=Updates from the 2020 World Health Organization Classification of Soft Tissue and Bone Tumours|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/his.14265|journal=Histopathology|language=en|volume=78|issue=5|pages=644–657|doi=10.1111/his.14265|issn=1365-2559|pmid=33438273|s2cid=231595171|url-access=subscription}}</ref> The fifth ''Female Genital Tumours'' was published in September 2020.<ref name=iccr>{{cite web |title=New WHO Classification for Female Genital Tumours - International Collaboration on Cancer Reporting |url=http://www.iccr-cancer.org/articles/new-who-classification-for-female-genital-tumours |website=www.iccr-cancer.org |date=2 September 2020 |access-date=8 July 2021}}</ref><ref name="FGT">{{cite book |last1=Board |first1=WHO Classification of Tumours Editorial |title=Female Genital Tumours |year=2020 |publisher=International Agency for Research on Cancer |isbn=978-92-832-4504-9 |url=https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/Female-Genital-Tumours-2020 |access-date=8 July 2021 |language=en}}</ref> The fifth edition of ''Thoracic Tumours'' was discussed at the 2020 World Conference on Lung Cancer in Toronto.<ref name="IASLC">{{cite web |title=The New WHO Classification of Lung Tumors |url=https://www.iaslc.org/iaslc-news/ilcn/new-who-classification-lung-tumors |website=IASLC |date=February 2021 |access-date=8 July 2021 |archive-url=https://web.archive.org/web/20210708152007/https://www.iaslc.org/iaslc-news/ilcn/new-who-classification-lung-tumors |archive-date=8 July 2021 |language=en}}</ref> It includes additional chapters "Diagnostic Molecular Pathology" and "Essential or Desirable Diagnostic Criteria", and some new lung cancer types.<ref name="IASLC"/>
*{{cite book |title=Digestive System Tumours|date=2019|publisher=International Agency for Research on Cancer |location=Lyon (France) |volume=1|isbn=978-92-832-4499-8 |edition=5th |url=https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/Digestive-System-Tumours-2019|language=English}}
*{{cite book |title=Breast Tumours|location=Lyon (France) |date=2019 |isbn=978-92-832-4500-1 |volume=2|edition=5th|url=https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/Breast-Tumours-2019|publisher=International Agency for Research on Cancer |language=English}}
*{{cite book |title=Soft Tissue and Bone Tumours|date=2020 |publisher=International Agency for Research on Cancer |location=Lyon (France) |volume=3|isbn=978-92-832-4502-5 |edition=5th |url=https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/Soft-Tissue-And-Bone-Tumours-2020|language=English}}
*{{cite book |title=Female Genital Tumours |date=2020 |publisher=International Agency for Research on Cancer |location=Lyon (France) |volume=4|isbn=978-92-832-4504-9 |edition=5th |url=https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/Female-Genital-Tumours-2020 |language=English}}
*{{cite book |title=Thoracic Tumours |date=2021 |publisher=International Agency for Research on Cancer |location=Lyon (France) |volume=5|isbn=978-92-832-4506-3 |edition=5th |url=https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours/Thoracic-Tumours-2021 |language=English}}
*{{cite book |title=Central Nervous System Tumours |date=2021 |publisher=International Agency for Research on Cancer |location=Lyon (France) |volume=6 |isbn=978-92-832-4508-7 |edition=5th |url=https://publications.iarc.who.int/Book-And-Report-Series/Who-Classification-Of-Tumours/Central-Nervous-System-Tumours-2021 |language=English}}
*{{cite book |title=Paediatric Tumours |date=2023 |publisher=International Agency for Research on Cancer |location=Lyon (France) |volume=7 |isbn=978-92-832-4510-0 |edition=5th |url=https://publications.iarc.who.int/Book-And-Report-Series/Who-Classification-Of-Tumours/Paediatric-Tumours-2023 |language=English}}
*{{cite book |title=Urinary and Male Genital Tumours |date=2022 |publisher=International Agency for Research on Cancer |location=Lyon (France) |volume=8 |isbn=978-92-832-4512-4 |edition=5th |url=https://publications.iarc.who.int/Book-And-Report-Series/Who-Classification-Of-Tumours/Urinary-And-Male-Genital-Tumours-2022 |language=English}}
*{{cite book |title=Head and Neck Tumours |date=2024 |publisher=International Agency for Research on Cancer |location=Lyon (France) |volume=9 |isbn=978-92-832-4514-8 |edition=5th |url=https://publications.iarc.who.int/Book-And-Report-Series/Who-Classification-Of-Tumours/Head-And-Neck-Tumours-2024 |language=English}}
==Consensus based versus evidence based approach== The method of classifying tumours in the Blue Books was discussed in an accompanying article in the ''International Journal of Cancer'' in June 2020, titled "WHO Classification of Tumours: How should tumors be classified? Expert consensus, systematic reviews or both?"<ref name="Uttley2020"/><ref name="Plass2020"/> In it, they noted that heavy reliance on expert consensus relative to structured and controlled systematic reviews may result in bias, giving undue weight to particular literature or missing relevant studies.<ref name="Uttley2020"/> In the first volume of the fifth series, 200 tumours or topics were marked as clinically irrelevant, and up to 130 were reported as "unknown", with no further explanation of whether a detailed literature search was conducted.<ref name="Uttley2020"/> Interpersonal and cultural factors, dominating characters, and the varying representations in each expert panel, influence decisions.<ref name="Uttley2020"/> During updating, carrying forward previously incorrectly referenced material could also be a potential problem.<ref name="Uttley2020"/>
The authors noted that biases are reduced somewhat by having an editorial board to oversee evidence and make decisions.<ref name="Uttley2020"/> They questioned whether these problems could also be reduced by adding evidence‐based practices to the editorial process, but noted that imposing this might not be appropriate, and that some feel that "clinical judgment based on experience" has an importance that may not be emphasised from randomized controlled trials.<ref name="Uttley2020"/> In conclusion, they proposed four "non‐negotiables" when carrying out literature reviews that affect important decisions for the WHO Blue Book series: transparency, searching rigor, double checking, risk of bias assessment.<ref name="Plass2020"/>
==See also== * Blue book (disambiguation)
==References== {{Reflist}}
==External links== *{{cite web |title=WHO Classification of Tumours Online |url=https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours|website=tumourclassification.iarc.who.int}}
{{Authority control}}
Category:World Health Organization Category:Book series Category:Medical books Category:Non-fiction books about cancer