International Classification of Childhood Cancer, third edition


  • The ICCC-3 benefited from many useful suggestions from pathologists, pediatricians, oncologists, and professionals involved in cancer registrations and standardization of methods, and the authors express their gratitude to them: Dr. Franco Berrino (Milan, Italy), Dr. Wojciech Biernat (Lyons, France), Dr. Jan Willem Coebergh (Eindhoven, Netherlands), Professor Norbert Graf (Homburg, Germany), Dr. Gernot Jundt (Basel, Switzerland), the late Professor Joachim Kühl (Würzburg, Germany), Dr. Corrado Magnani (Turin, Italy), Professor Jill Mann (Birmingham, United Kingdom), Professor Charlotte Niemeyer (Freiburg, Germany), Dr. David Parham (Little Rock, Arkansas), Dr. Max Parkin (Lyons, France), Dr. Jane Passmore (Oxford, United Kingdom), Professor Alfred Reiter (Giessen, Germany), Dr. Lynn Ries (Bethesda, Maryland), Dr. Kanagaratnam Shanmugarathnan (Singapore), Dr. Claudia Spix (Mainz, Germany), Dr. Elisabeth van Wering (Hague, Netherlands), and Dr. Xiao-Cheng Wu (New Orleans, Louisiana).

  • Supported by the European Commission in the framework of the Europe Against Cancer program (agreements SI2.126875, SI2.321970, and SPC.2002303) jointly with the International Agency for Research on Cancer. The Childhood Cancer Research Group receives funding from the Department of Health and the Scottish Ministers. The views expressed in this publication are those of the authors and not necessarily those of the Department of Health and the Scottish Ministers.



The third edition of the International Classification of Diseases for Oncology (ICD-O-3), which was published in 2000, introduced major changes in coding and classification of neoplasms, notably for leukemias and lymphomas, which are important groups of cancer types that occur in childhood. This necessitated a third revision of the 1996 International Classification of Childhood Cancer (ICCC-3).


The tumor categories for the ICCC-3 were designed to respect several principles: agreement with current international standards, integration of the entities defined by newly developed diagnostic techniques, continuity with previous childhood classifications, and exhaustiveness.


The ICCC-3 classifies tumors coded according to the ICD-O-3 into 12 main groups, which are split further into 47 subgroups. These 2 levels of the ICCC-3 allow standardized comparisons of the broad categories of childhood neoplasms in continuity with the previous classifications. The 16 most heterogeneous subgroups are broken down further into 2–11 divisions to allow study of important entities or homogeneous collections of tumors characterized at the cytogenetic or molecular level. Some divisions may be combined across the higher-level categories, such as the B-cell neoplasms within leukemias and lymphomas.


The ICCC-3 respects currently existing international standards and was designed for use in international, population-based, epidemiological studies and cancer registries. The use of an international classification system is especially important in the field of pediatric oncology, in which the low frequency of cases requires rigorous procedures to ensure data comparability. Cancer 2005. © 2005 American Cancer Society.