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Cancer Staging Documentation

American Joint Committee on Cancer (AJCC) + Heretto


Heretto Enables Content Interoperability For Medical Documentation



Page manual updated regularly
Direct Interfacing
Between the Cancer Staging Manual and Health Information Systems via APIs.


The American Joint Committee on Cancer (AJCC) provides worldwide leadership in the development, promotion and maintenance of evidence-based systems for the classification and management of cancer in collaboration with multidisciplinary organizations dedicated to cancer surveillance and to improving care. AJCC’s publications are recognized as the authoritative guides for cancer staging information and are used by tens of thousands of medical professionals every day.

Historically, they delivered their Cancer Staging Manual as a bound reference text. However, with over 80 chapters and 1000 pages of information, accessing specific, relevant content required a time-consuming physical search through the book. With the advent of widely used health information systems, the AJCC needed to restructure the information in the manual for digital delivery.

In addition, clinicians needed the ability to annotate patient files with information found in the Staging Manual. Integrating this complex information into health information systems, however, required the developers of these systems to manually convert the information into digital formats, organize it, then import it. This manual process was time-consuming and potentially error-prone.


AJCC used Heretto to build a single source, scalable content creation and delivery system that offers:

  • A robust CCMS platform with metadata and tagging capabilities, for quick searches and delivery of the information requested by the doctor.
  • Standards-based APIs, for easy integration with other systems.
  • An authoring and review process that is easy to learn and implement.


Structuring the content in the Manual and centralizing it as XML files in the Heretto database made it possible to deliver organized, properly formatted, and searchable information on cancer staging directly to existing health information systems.

Key results include:

  • Authoring, editing, and review processes for over 400 contributors are dramatically simplified.
  • Users have instant access to the Staging Manual on screen while they complete charts in real-time.
  • Centralized, structured content architecture with rich metadata provides a single source of content that can be shared with other organizations using the content for their own data collection.
  • Information is now accessible in clinical and research environments, enabling more frequent updates and additions to the current state of cancer staging assessment.
  • The Cancer Staging Manual can now interface directly with Health Information Systems (HIS) via APIs.

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