12.1. CONCEPT OF PRECANCER
To date, the precise causes of malignant neoplasia and the mechanisms of their development are not completely understood, so effective prevention consists mostly in early detection and treatment of so called precancerous conditions.
The words precancer, precancerous lesion were first used in Russia in 1898. A Russian oncologist N.N. Petrov emphasized that the notion of precancer describes not only the morphology of condition but also clinical presentations and changes in condition.
The carcinogenesis theory regards development of cancer as a series of phases constituting one process. The first phase is diffuse pathologic hyperplasia, the second one - development of focal proliferates, the third - benign tumor emerging, and the fourth - development of a malignant tumor. According to this theory, precancer proper is constituted by the second and third phase (obligate forms) while the first stage is an unfavorable context for the development of precancer and cancer (facultative form).
Diagnosis of precancer is based on changes in morphology. It is important to obtain detailed information about the patient, especially of the development and changes in the pathologic process. The final diagnosis is formulated by the clinician with consideration to the findings of all investigations including histology report.
ICD-10 Code
ICD-10 provides no code for a separate group of precancerous conditions of female genitals.