DHIS2 Cancer Registry Toolkit — Webinar Q&A
Thank you to everyone who joined the webinar and for the many excellent questions submitted during the session. Below we have compiled answers to all questions received. Please don’t hesitate to follow up in this thread or in the dedicated CoP topic linked at the bottom of this post.
What coding standards are used for tumour registration?
The toolkit uses ICD-O-3.2 (International Classification of Diseases for Oncology, 3rd edition, version 2) for tumour coding at the point of registration — the same standard used in CanReg5 and the current operational standard for population-based cancer registration worldwide. Separate codes are recorded for topography (site) and morphology (histological type and behaviour). ICD-11 is not yet incorporated, as ICD-O-4 — which would align with ICD-11 — is scientifically finalised but not yet in operational use. The toolkit has been designed to anticipate a future transition to ICD-O-4.
Where can we access the toolkit, documentation, and a training instance?
The reference metadata package is available at Metadata Downloads - DHIS2. The full System Design Guide is available at: Design - DHIS2 Documentation
A public demo instance is available at https://demos.dhis2.org/hmis where you can explore the tracker configuration.
How does the auto-generated Patient ID work, and can it be modified or aligned with national patient identifiers?
The Patient ID is automatically generated following the same convention used in CanReg5: an 8-character identifier composed of the current year in four-digit format followed by a four-digit sequential number (YYYY####). The Patient ID pattern should be aligned with the CanReg5 instance used in the local implementation — the standard YYYY#### format is the default and matches the CanReg5 convention. Modifying the ID pattern is technically possible in DHIS2 but must be done carefully to preserve alignment with the local CanReg5 configuration and the TUMOURID logic used in data extraction. If a national patient identifier exists, it can be captured as an additional tracked entity attribute alongside the auto-generated registry ID.
Can the toolkit be used by registries not currently using CanReg5, or registries using a different platform? Is bulk import of existing data supported?
The toolkit is designed as a data capture system aligned with CanReg5 standards, with a custom export application that produces a CanReg5-compatible file for import into CanReg5. It is not designed to ingest data from other registry platforms directly. However, since DHIS2 is a platform-based system with standard import/export capabilities and open APIs, integration with other systems or custom migration solutions can be implemented. Existing case data can in principle be loaded into the tracker provided it can be mapped to the DHIS2 data model, either using DHIS2’s native import tools or through a custom integration layer.
How do we transition from CanReg5 to DHIS2, and how is patient continuity and deduplication managed?
The DHIS2 Cancer Registry toolkit is not a replacement for CanReg5 — it is a complementary data capture layer. DHIS2 can be used for individual-level case registration and quality control, with the custom export application transferring data to CanReg5 for analysis and reporting. DHIS2’s tracker supports patient search and deduplication workflows at the point of registration. More advanced deduplication capabilities can be developed as custom solutions on top of the DHIS2 platform where local requirements demand it.
Can the toolkit be adapted for other chronic diseases?
Yes. DHIS2 is a fully flexible, open-source platform, and its configuration — including tracker programs, data elements, program rules, and analytics — can be adapted to virtually any disease registry or health data use case. The design patterns used in this toolkit are directly reusable for other chronic disease registries. DHIS2 already has metadata toolkits covering several other NCD and health programme areas, and the same approach can be applied to build registries for other conditions.
Does DHIS2 support HL7-FHIR interoperability?
DHIS2 does not use HL7-FHIR as its internal data standard, but it does support interoperability with FHIR-based systems through external integration layers. The WHO SMART Guidelines initiative and the OpenHIE community have developed FHIR-to-DHIS2 integration patterns. The Cancer Registry toolkit itself does not include a FHIR interface, but this could be developed as part of a broader national health information architecture where needed.
What advantages does DHIS2 offer over CanReg5 for data collection? Can it be used offline? Can it be used for analysis and presentation only?
The primary advantage of DHIS2 for data collection is integration with national health information infrastructure: many LMICs already use DHIS2 as their routine health information system, so embedding cancer registration within the same platform reduces duplication, simplifies user access management, and supports long-term sustainability. DHIS2 is web-based and supports concurrent use by multiple data entry staff simultaneously — a significant operational advantage over standalone desktop software. Regarding offline use, DHIS2 supports offline data entry through its Android Capture app for mobile devices, though the full web-based tracker works best with a reliable internet connection. Using DHIS2 purely as a presentation and analysis layer fed by CanReg5 data is not the primary intended use case of this toolkit; CanReg5 itself provides robust analytical capabilities designed specifically for cancer registry analysis.
What are the next steps for a country that already has a national DHIS2 instance?
Countries with an existing national DHIS2 instance can import the Cancer Registry metadata package. The recommended steps are: (1) download the metadata package from Metadata Downloads - DHIS2; (2) install and test it in a dedicated development or staging instance — never directly in production; (3) carry out local adaptation, in particular customising the address codes and source type values; (4) configure user groups and access controls; and (5) conduct staff training before going live. Technical support is available through HISP Groups and IARC. In case of any questions don’t hesitate to contact us through the CoP
Can the address and geographic coding be customised to support disease distribution mapping?
Yes. The address field in the baseline configuration uses placeholder values that must be customised prior to implementation to reflect the administrative geography of the country or region. The recommended approach uses cascading dropdown lists implemented through DHIS2 program rules, allowing registry staff to select administrative regions and sub-regions sequentially. Once geographic coding is in place, DHIS2’s built-in mapping and analytics features can be used to generate disease distribution visualisations at different administrative levels.
Is there integration with pathology laboratories?
The toolkit supports the capture of pathology and cytology laboratory reports as sources of notification within the Sources stage. Each source record can be linked to a specific tumour, allowing pathology reports to be recorded alongside hospital records and death certificates as contributing documentation for a registered case. The Type of Source field uses placeholder values in the baseline configuration and must be customised to reflect local source types, including pathology and cytology laboratories. Direct electronic integration with laboratory information systems (LIS) is not part of the current toolkit scope, but given that DHIS2 is an open platform with standard APIs, custom integrations with LIS can be developed where needed.
Where is the data hosted?
DHIS2 is a self-hosted platform. The data is housed on the server infrastructure of the implementing country or organisation — typically managed by the Ministry of Health or a designated technical agency. Cloud hosting options are also available. The toolkit itself does not prescribe or include a hosting arrangement; this is determined by each national DHIS2 implementation.
Is DHIS2 open-source?
Yes. DHIS2 is free and open-source software, developed and maintained by the University of Oslo (HISP UiO) and released under the BSD licence. The source code is publicly available on GitHub. The Cancer Registry toolkit metadata is freely available at Metadata Downloads - DHIS2.
For further questions or to connect with others implementing the toolkit, please reply to the original release announcement on the DHIS2 Community of Practice: New Release: DHIS2 Cancer Registry Toolkit in collaboration with Vital Strategies and IARC — or start a new discussion in the NCD implementation section of the CoP: Noncommunicable Diseases - DHIS2 Community
Webinar: DHIS2 Cancer Registry Toolkit Launch (Part 1)
Webinar Date: 2026-03-24T13:00:00Z→2026-03-24T14:00:00Z
