Quality communication between clinicians and pathologists is required for optimal cancer care. The College of American Pathologists provides anatomic site–specific cancer protocols that facilitate synoptic reporting for efficient communication, contributing to accuracy and completeness of cancer staging.
To evaluate synoptic cancer pathology reporting across the Department of Veterans Affairs (VA), the largest integrated health system in the United States, for 4 common cancers: melanoma and colon, bladder, and kidney cancer.
For each cancer type, we investigated at least 200 biopsy and 200 resection reports from 2019 to 2021. In each report, we determined whether a synoptic format was used. The reports were selected using random sampling across all VA health care facilities. We also identified a set of core elements that were underdocumented.
Among 1618 pathology reports, 778 (48%; 95% CI, 46%–50%) were synoptic reports. Synoptic reporting was much more common among resections (621 of 811; 77%; 95% CI, 74%–79%) than among biopsies (157 of 807; 19%; 95% CI, 17%–22%). It was most common in colorectal resections (200 of 206; 97%; 95% CI, 94%–99%) and least common in colon biopsy reports (1 of 200; 0.5%; 95% CI, 0%–3%). Core elements that were underdocumented included procedure and regional lymph nodes for resections of bladder and kidney cancer and of melanoma.
Synoptic reporting was used about three-quarters of the time for resections and about 1 in 5 times for biopsies. Future work should develop implementation strategies to improve synoptic reporting, especially for biopsy specimens and core elements that were relatively underdocumented.
Author notes
This work is supported by residual research funds administered by the Veterans Education & Research Association of Northern New England (VERANNE). The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
DuVall reports grants from Alnylam Pharmaceuticals, Inc; Astellas Pharma, Inc; AstraZeneca Pharmaceuticals LP; Biodesix, Inc; Celgene Corporation; Cerner Enviza; GSK PLC; IQVIA Inc; Janssen Pharmaceuticals, Inc; Moderna, Inc; Novartis International AG; and Parexel International Corporation through the University of Utah or Western Institute for Veterans Research outside the submitted work within the last 36 months. Schroeck reports research funding from Pacific Edge Ltd, Cepheid, and Nucleix. The other authors have no relevant financial interest in the products or companies described in this article.
Opinions expressed in this manuscript are those of the authors and do not constitute official positions of the US federal government or the Department of Veterans Affairs.