The use of a proforma improves colorectal cancer pathology reporting

The detail and accuracy of pathological reporting for colorectal cancer is becoming increasingly recognised as important in the overall management of the patient. However, there is criticism of the variable standards of repor ting. We assessed how the use of a proforma affected the completeness of re porting within one hospital. Data on all colorectal cancer patients attending one teaching; hospital has been collected prospectively over a 15 month period from 1997 to 1998. The Royal College of Surgeons/Association of Coloproctology proforma lists all items considered to be essential for a complete pathological report of col orectal cancer. Its introduction in September 1997 allowed us to compare re porting before the proforma to that after. Of 54 patients, 46 (85%) had one or more items missing from their report be fore introduction of the proforma compared with only 8/44 (18%) patients af ter the proforma (P<0.001). Circumferential resection margins and apical no de status were the items most often absent, being significantly more freque ntly reported after the proforma (P<0.05 and P<0.001 respectively). There w as no difference in the median number of lymph nodes harvested after profor ma introduction. The introduction of the proforma has not only resulted in improvements in r eporting, but has increased the dialogue between surgical oncologists and p athologists. These features should result in improved overall management of the colorectal cancer patient.