COLORECTAL-CANCER PATHOLOGY REPORTING - A REGIONAL AUDIT (VOL 50, PG 138, 1997)

Aims-To audit the information content of pathology reports of colorect al cancer specimens in one National Health Service region. Methods-All reports of colorectal cancer resection specimens from the 17 NHS hist opathology laboratories in Wales during 1993 were evaluated against: ( a) standards previously agreed as desirable by pathologists in Wales; and (b) standards considered to be the minimum required for informed p atient management. Results-1242 reports were audited. There was notabl e variation in the performance of different laboratories and in the co mpleteness of reporting of individual items of information. While many items were generally well reported, only 51.5% of rectal cancer repor ts contained a statement on the completeness of excision at the circum ferential resection margin and only 30% of all reports stated the numb er of involved lymph nodes. All of the previously agreed items were co ntained in only 11.3% of reports on colonic tumours and 4.0% of report s on rectal tumours. Seventy eight per cent of colonic carcinoma repor ts and 46.6% of rectal carcinoma reports met the minimum standards. Co nclusions-The informational content of many routine pathology reports on colorectal cancer resection specimens is inadequate for quality pat ient management, for ensuring a clinically effective cancer service th rough audit, and for cancer registration. Template proforma reporting using nationally agreed standards is recommended as a remedy for this, along with improved education, review of laboratory practices in the light of current knowledge, and further motivation of pathologists thr ough their involvement in multidisciplinary cancer management teams.