Legal Framework

The legal framework for the reporting procedure is defined in the Cancer Registry Act (BremKRG). Here we tell you for whom reporting is obligatory, when you need to make a report and which deadlines you need to observe.

Obligation to report

On various occasions, hospitals and medical and dental practices in Bremen are obligated to report information about the cancer patients they treat to the Bremen Cancer Registry—regardless of their patients’ place of residence.

Diagnostic spectrum

All malignant neoplasms, including their early forms and benign tumors of the central nervous system are subject to mandatory reporting. The non-melanocytic skin cancer tumors (ICD-10 C44) are an exception. Since the amendment of the Bremen Cancer Registry Act of 18/04/2023, only the prognostically unfavorable non-melanocytic skin tumors are reportable. A list of these can be found here. Other skin tumors of the diagnosis group ICD-10 C44 are no longer recorded.

With a few exceptions, tumors must be reported separately if they occur on both sides of paired organs. For colon carcinomas, malignant melanomas as well as prognostically unfavorable non-melanocytic skin tumors each sub-localization should be documented separately.

Cancer diseases to be reported according to ICD-10

invasive¹	in situ	uncertain behavior	benign (CNS)
C00-C96²	D00-D09; excl. D04	D39.1, D41.4, D42, D43, D45.3-4. D45, D46, D47.1, D47.3-5	D32, D33, D35.2-4

¹Secondary malignant neoplasms (C77-C79) are not documented as separate diagnosis but as metastasis of the respective primary tumor. Neoplasms with metastases of unknown primary tumor site (CUP) should be coded as C80.0. Malignant neoplasms which are primary tumors at multiple sites (C97) should be coded separately.
²In the diagnosis group ICD-10 C44 only skin tumors with unfavourable prognosis are recorded (see the list of non-melanocytic skin tumors with unfavorable prognosis).

Reporting occasions

Reports to the cancer registry are mandatory at the following times:

Detection of cancer,
Confirmation of the diagnosis by fine-tissue or cell-related examinations,
Start, termination or discontinuation of treatment,
Changes of disease status relevant to therapy or recurrence of the disease,
Death from or with cancer.

If a report has been submitted to the Bremen Cancer Registry for one of the above-mentioned reasons, a reporting institution may also submit further data for completion in accordance with the basic oncology data set, irrespective of the reason for reporting. Data that were not collected as part of the institution's own treatment should be marked in the field provided for this purpose in the oBDS.

Reporting deadline

Reports have to be transmitted to the trust center of the Bremen Cancer Registry in a timely manner, no later than six weeks after the occurrence of the reason for reporting.

Institutions that do not comply with their reporting obligation, report incompletely or with delay can be fined up to €50,000.

More information on the reporting process can be downloaded here:

Legal requirements
List of diagnoses
List of paired organs