In response to user and member feedback, the CAP has moved to a twice yearly publication schedule for the CAP Cancer Protocols. If there are updates, revisions, or new protocols to be released, this will be done on a February and August schedule.

CAP Cancer Protocol Templates provide guidelines for collecting the essential data elements for complete reporting of malignant tumors and optimal patient care.

The Cancer Biomarker Reporting Templates are intended to provide reporting guidance for commonly ordered biomarkers and are not currently required for accreditation purposes.

Read the cancer protocol frequently asked questions.
Download the definition of Synoptic Reporting With Examples.
Visit the cancer protocol resources webpage to read about current issues with units of measurements.
Integrate the Cancer Protocol & Biomarker Templates into your LIS workflow. Learn about our eCC (electronic Cancer Checklists) and eFRM (electronic Forms and Reporting Module)
Download a compressed file containing all of current CAP cancer protocols.
The August 2018 release contains 21 revised protocols and four revised biomarker templates. Download the summary of revisions including public comments.
Download the summary of required elements.
Visit the ASCO Molecular Oncology Tumor Board for bi-monthly user-driven discussions.
Provide your feedback about the CAP cancer protocols to cprotoc@cap.org.

Current and previous cancer protocols and cancer biomarker reporting templates can be downloaded using the links in the table below.

# Protocols and Biomarker Templates with the # notation in the table below have changes in the August 2018 release that do not affect the core elements. The earlier date denotes the last time the core elements were changed and coincides with the date noted in the documents.

Protocols

Breast

DCIS – Breast	Current Version PDF (v4.1.0.0) Word (v4.1.0.0) January 2018	Previous Version 2017 (v4.0.0.0) 2013 (v3.2.0.0) 2012 (v3.1.0.0)
Invasive Breast	Current Version PDF (v4.1.0.0) Word (v4.1.0.0) January 2018	Previous Version 2017 (v4.0.0.0) 2016 (v3.3.0.0) 2013 (v3.2.0.0)

Central Nervous System

Brain/Spinal Cord

Current Version
PDF (v4.0.0.0)
Word (v4.0.0.0)
August 2018

Previous Version
2014 (v3.1.0.2)
2014 (v3.1.0.1)
2013 (v3.1.0.0)

Endocrine

Adrenal Gland	Current Version PDF (v4.0.1.1) Word (v4.0.1.1) June 2017	Previous Version 2017 (v4.0.1.0) 2013 (v3.2.0.0) 2011 (v3.1.0.1)
Appendix NET	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) June 2017	Previous Version 2017 (v4.0.0.0) 2013 (v3.2.0.1) 2012 (v3.2.0.0)
Colon NET	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) June 2017	Previous Version 2017 (v4.0.0.0) 2013 (v3.2.0.1) 2012 (v3.2.0.0)
Duodenum and Ampulla NET	Current Version PDF (v1.0.0.1) Word (v1.0.0.1) June 2017	Previous Version 2017 (v1.0.0.0)
Jejunum and Ileum NET	Current Version PDF (v1.0.0.1) Word (v1.0.0.1) June 2017	Previous Version 2017 (v1.0.0.0)
Pancreas (Endocrine)	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) June 2017	Previous Version 2017 (v4.0.0.0) 2016 (v3.3.0.1) 2016 (v3.3.0.0)
Small Intestine NET (Retired)	Current Version See Duodenum and Ampulla NET See Jejunum and Ileum NET Retired June 2017	Previous Version 2013 (v3.3.0.0)
Stomach NET	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) June 2017	Previous Version 2017 (v4.0.0.0) 2013 (v3.3.0.0) 2012 (v3.2.0.0)
Thyroid	Current Version PDF (v4.0.0.0) Word (v4.0.0.0) June 2017	Previous Version 2016 (v3.2.0.0) 2014 (v3.1.0.0)

Gastrointestinal

Ampulla of Vater	Current Version PDF (v4.0.0.0) Word (v4.0.0.0) June 2017	Previous Version 2016 (v3.2.0.0) 2013 (v3.1.0.2)
Anus	Current Version PDF (v4.0.1.0) Word (v4.0.1.0) June 2017	Previous Version 2013 (v3.2.0.1) 2012 (v3.2.0.0)
Appendix	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) (June 2017^#) August 2018	Previous Version 2017 (v4.0.0.0) 2016 (v3.4.0.0) 2013 (v3.3.0.0)
Colon and Rectum	Current Version PDF (v4.0.1.0) Word (v4.0.1.0) (June 2017^#) August 2018	Previous Version 2017 (v4.0.0.0) 2016 (v3.4.0.0) 2013 (v3.3.0.0)
Distal Extrahepatic Bile Ducts	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) (June 2017^#) August 2018	Previous Version 2017 (v4.0.0.0) 2016 (v3.6.0.0) 2016 (v3.5.0.0)
Esophagus	Current Version PDF (v4.0.0.0) Word (v4.0.0.0) June 2017	Previous Version 2016 (v3.2.0.0) 2013 (v3.1.1.2)
Gallbladder	Current Version PDF (v4.0.0.0) Word (v4.0.0.0) June 2017	Previous Version 2013 (v3.1.0.2) 2012 (v3.1.0.1)
GIST	Current Version PDF (v4.0.1.0) Word (v4.0.1.0) (June 2017^#) August 2018	Previous Version 2017 (v4.0.0.1) 2014 (v3.1.0.0) 2013 (v3.0.2.2)
Hepatocellular Carcinoma	Current Version PDF (v4.0.0.0) Word (v4.0.0.0) June 2017	Previous Version 2011 (v3.1.0.0)
Intrahepatic Bile Ducts	Current Version PDF (v4.0.0.0) Word (v4.0.0.0) June 2017	Previous Version 2013 (v3.1.0.2) 2012 (v3.1.0.1)
Pancreas (Exocrine)	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) June 2017	Previous Version 2017 (v4.0.0.0) 2016 (v3.4.0.0) 2016 (v3.3.0.1)
Perihilar Bile Ducts	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) June 2017	Previous Version 2017 (v4.0.0.0) 2013 (v3.1.0.2) 2012 (v3.1.0.1)
Small Intestine	Current Version PDF (v4.0.0.0) Word (v4.0.0.0) June 2017	Previous Version 2013 (v3.2.0.0) 2012 (v3.1.0.2)
Stomach	Current Version PDF (v4.0.0.0) Word (v4.0.0.0) June 2017	Previous Version 2014 (v3.3.0.0) 2013 (v3.2.0.1)

Genitourinary

Kidney	Current Version PDF (v4.0.1.1) Word (v4.0.1.1) June 2017	Previous Version 2017 (v4.0.1.0) 2017 (v3.3.0.0) 2013 (v3.2.0.0)
Penis	Current Version PDF (v4.0.1.0) Word (v4.0.1.0) June 2017	Previous Version 2017 (v3.3.1.0) 2013 (v3.2.0.0)
Prostate Gland	Current Version PDF (v4.0.3.0) Word (v4.0.3.0) (June 2017^#) August 2018	Previous Version 2017 (v4.0.2.0) 2017 (v4.0.1.0) 2017 (v3.3.0.0) 2012 (v3.2.0.0)
Testis	Current Version PDF (v4.0.1.0) Word (v4.0.1.0) June 2017	Previous Version 2017 (v3.4.1.0) 2013 (v3.3.0.0)
Ureter, Renal Pelvis	Current Version PDF (v2.1.0.0) Word (v2.1.0.0) June 2017	Previous Version 2017 (v1.0.0.0) 2013 (v3.4.0.0)
Urethra	Current Version PDF (v4.0.1.1) Word (v4.0.1.1) June 2017	Previous Version 2017 (v4.0.1.0) 2017 (v3.3.0.0) 2012 (v3.2.1.0)
Urinary Bladder	Current Version PDF (v4.0.1.0) Word (v4.0.1.0) June 2017	Previous Version 2017 (v3.3.0.0) 2012 (v3.2.1.0)

Gynecologic

Endometrium	Current Version PDF (v4.1.0.0) Word (v4.1.0.0) August 2018	Previous Version 2017 (v4.0.0.0) 2016 (v3.3.0.0) 2013 (v3.2.0.1)
Ovary, Fallopian Tube, Peritoneum	Current Version PDF (v1.1.0.0) Word (v1.1.0.0) August 2018	Previous Version 2017 (v1.0.0.1) 2017 (v1.0.0.0) 2016(v1.0.0.0) 2015 (v3.2.0.1)
Trophoblastic Tumors	Current Version PDF (v4.0.0.0) Word (v4.0.0.0) June 2017	Previous Version 2016 (v3.1.0.0) 2013 (v3.0.0.3)
Uterine Cervix	Current Version PDF (v4.1.0.0) Word (v4.1.0.0) August 2018	Previous Version 2017 (v4.0.0.1) 2016 (v3.3.0.0) 2013 (v3.2.1.0)
Uterine Sarcoma	Current Version PDF (v4.1.0.0) Word (v4.1.0.0) August 2018	Previous Version 2017 (v4.0.0.0) 2016 (v3.1.0.0) 2013 (v3.0.0.0)
Vagina	Current Version PDF (v4.1.0.0) Word (v4.1.0.0) August 2018	Previous Version 2017 (v4.0.0.1) 2016 (v3.2.0.0) 2013 (v3.1.0.3)
Vulva	Current Version PDF (v4.1.0.0) Word (v4.1.0.0) August 2018	Previous Version 2017 (v4.0.0.1) 2016 (v3.2.0.0) 2012 (v3.1.0.1)

Head and Neck

Larynx	Current Version PDF (v4.0.0.1) Word v4.0.0.1) (June 2017^#) August 2018	Previous Version 2017 (v4.0.0.0) 2013 (v3.3.0.0) 2012 (v3.2.0.0)
Lip and Oral Cavity	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) (June 2017^#) August 2018	Previous Version 2017 (v4.0.0.0) 2016 (v3.3.0.0) 2013 (v3.2.0.0)
Major Salivary Glands	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) (June 2017^#) August 2018	Previous Version 2017 (v4.0.0.0) 2013 (v3.2.0.0) 2012 (v3.1.0.2)
Nasal Cavity and Paranasal Sinuses	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) (June 2017^#) August 2018	Previous Version 2017 (v4.0.0.0) 2013 (v3.2.0.0) 2012 (v3.1.0.1)
Pharynx	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) (June 2017^#) August 2018	Previous Version 2017 (v4.0.0.0) 2013 (v3.3.0.0) 2012 (v3.2.0.0)
Squamous Cell Carcinoma (Retired)	Current Version The CAP does not currently offer a cutaneous squamous cell carcinoma (SCC) of the head and neck but may reconsider at a later date to support the available AJCC 8 edition TNM content. Cutaneous squamous cell carcinoma and basal cell carcinoma outside the head and neck: There is no TNM staging system so these tumors are not staged. CAP Laboratory Accreditation Program and the Commission on Cancer (CoC) do NOT require that these tumors be reported using the CAP Cancer Protocols.	Previous Version Retired July 2017

Hematologic

Bone Marrow	Current Version PDF (v3.1.0.0) Word (v3.1.0.0) January 2018	Previous Version 2017 (v3.0.1.2) 2012 (v3.0.1.1)
Hodgkin Lymphoma	Current Version PDF (v3.1.0.1) Word (v3.1.0.1) October 2013	Previous Version 2013 (v3.1.0.0) 2012 (v3.0.0.0)
Non-Hodgkin Lymphoma	Current Version PDF (v3.2.0.1) Word (v3.2.0.1) October 2013	Previous Version 2013 (v3.2.0.0)
Ocular Adnexal Lymphoma (Retired)	Current Version No longer required for accreditation as of September 2017	Previous Version 2010 (v3.0.0.0)
Plasma Cell Neoplasms	Current Version PDF (v1.0.0.2) Word (v1.0.0.2) January 2015	Previous Version 2015 (v1.0.0.1) 2015 (v1.0.0.0)

Ophthalmic

Retinoblastoma	Current Version PDF (v4.0.0.0) Word (v4.0.0.0) June 2017	Previous Version 2016 (v3.2.0.0) 2013 (v3.1.0.0)
Uveal Melanoma	Current Version PDF (v4.0.0.0) Word (v4.0.0.0) June 2017	Previous Version 2016 (v3.3.0.0) 2013 (v3.2.0.0)

Pediatric

Ewing Sarcoma	Current Version PDF (v3.2.0.2) Word (v3.2.0.2) August 2016	Previous Version 2016 (v3.2.0.1) 2016 (v3.2.0.0) 2012 (v3.1.0.2)
Extragonadal Germ Cell	Current Version PDF (v3.1.0.2) Word (v3.1.0.2) August 2016	Previous Version 2016 (v3.1.0.1) 2016 (v3.1.0.0) 2011 (v3.0.0.1)
Hepatoblastoma	Current Version PDF (v3.2.0.2) Word (v3.2.0.2) August 2016	Previous Version 2016 (v3.2.0.1) 2016 (v3.2.0.0) 2013 (v3.1.1.1)
Neuroblastoma	Current Version PDF (v3.1.0.3) Word (v3.1.0.3) (August 2016^#) August 2018	Previous Version 2016 (v3.1.0.2) 2016 (v3.1.0.1) 2016 (v3.1.0.0) 2012 (v3.0.0.1)
Rhabdomyosarcoma	Current Version PDF (v3.2.0.2) Word (v3.2.0.2) August 2016	Previous Version 2016 (v3.2.0.1) 2016 (v3.2.0.0) 2011 (v3.1.0.0)
Wilms Tumor	Current Version PDF (v3.2.0.2) Word (v3.2.0.2) August 2016	Previous Version 2016 (v3.2.0.1) 2016 (v3.2.0.0) 2012 (v3.1.0.2)

Skin

Melanoma	Current Version PDF (v4.0.1.0) Word (v4.0.1.0) (June 2017^#) August 2018	Previous Version 2017 (v4.0.0.1) 2017 (v4.0.0.0) 2016 (v3.4.0.0) 2015 (v3.3.0.1)
Merkel Cell Carcinoma	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) June 2017	Previous Version 2017 (v4.0.0.0) 2012 (v3.0.1.1)
Squamous Cell Carcinoma (Retired)	Current Version Not currently available. See Head and Neck section for more information.	Previous Version See Head and Neck section.

Thorax

Heart (Retired)	Current Version No longer required for accreditation as of July 2017	Previous Version PDF (v3.0.0.0) Word (v3.0.0.0) October 2009 Retired June 2017
Lung	Current Version PDF (v4.0.0.3) Word (v4.0.0.3) (June 2017^#) August 2018	Previous Version 2017 (v4.0.0.2) 2017 (v4.0.0.1) 2017 (v4.0.0.0) 2016 (v3.4.0.0) 2013 (v3.3.0.0)
Pleural Mesothelioma	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) June 2017	Previous Version 2017 (v4.0.0.0) 2011 (v3.1.0.0)
Thymus	Current Version PDF (v4.0.0.1) Word (v4.0.0.1) June 2017	Previous Version 2017 (v4.0.0.0) 2011 (v3.1.0.0)

Other

Bone	Current Version PDF (v4.0.0.0) Word (v4.0.0.0) June 2017	Previous Version 2013 (v3.1.1.1)
Peritoneum	Current Version See Ovary, Fallopian Tube, Peritoneum June 2017	Previous Version 2015 (v3.2.0.1) 2012 (v3.1.0.0) Previous Versions
Soft Tissue	Current Version PDF (v4.0.1.0) Word (v4.0.1.0) (June 2017^#) August 2018	Previous Version 2017 (v4.0.0.0) 2013 (v3.1.2.0) 2012 (3.1.1.0)

Biomarker Templates

Biomarker Templates are not currently required for accreditation purposes.

Head & Neck

Head & Neck Reporting

Current Version
PDF (v1.0.0.0)
Word (v1.0.0.0)
February 2017

Breast

Breast Biomarker Reporting

Current Version
PDF (v1.2.0.1)
Word (v1.2.0.1)
(January 2018^#)
August 2018

Previous Version
2018 (v1.2.0.0)
2014 (v1.1.0.0)
2013 (v1.0.0.0)

CNS

Central Nervous System Biomarker Reporting
Retired

Current Version
Not currently available. See CNS Cancer Protocol that includes the biomarker template.

Previous Version
PDF (v1.1.0.0)
Word (v1.1.0.0)
December 2014

Endocrine

Thyroid Biomarker Reporting

Current Version
PDF (v1.0.0.1)
Word (v1.0.0.1)
June 2016

Previous Version
2015 (v1.0.0.0)

Gastrointestinal

Colon and Rectum Biomarker Reporting	Current Version PDF (v1.2.0.1) Word (v1.2.0.1) (December 2014^#) August 2018	Previous Version 2014 (v1.2.0.0) 2013 (v1.0.0.0)
GIST Biomarker Reporting	Current Version PDF (v1.0.0.1) Word (v1.0.0.1) March 2015	Previous Version 2014 (v1.0.0.0)
Gastric HER2 Biomarker Reporting	Current Version PDF (v1.0.0.1) Word (v1.0.0.1) June 2017	Previous Version 2014 (v1.0.0.0)

Gynecologic

Endometrium Biomarker Reporting

Current Version
PDF (v1.1.0.0)
Word (v1.1.0.0)
June 2016

Previous Version
2015 (v1.0.0.0)

Hematologic

Chronic Lymphocytic Leukemia Biomarker Reporting	Current Version PDF (v1.0.0.2) Word (v1.0.0.2) July 2015	Previous Version 2015 (v1.0.0.1) 2014 (v1.0.0.0)
Chronic Myelogenous Leukemia Biomarker Reporting	Current Version PDF (v1.0.0.2) Word (v1.0.0.2) July 2015	Previous Version 2015 (v1.0.0.1) 2014 (v1.0.0.0)
Diffuse Large B-Cell Lymphoma Biomarker Reporting	Current Version PDF (v1.0.0.2) Word (v1.0.0.2) July 2015	Previous Version 2015 (v1.0.0.1) 2014 (v1.0.0.0)
Myeloproliferative Neoplasms Biomarker Reporting	Current Version PDF (v1.0.0.2) Word (v1.0.0.2) July 2015	Previous Version 2015 (v1.0.0.1) 2014 (v1.0.0.0)

Skin

Melanoma Biomarker Reporting

Current Version
PDF (v1.0.0.2)
Word (v1.0.0.2)
July 2015

Previous Version
2015 (v1.0.0.1)
2015 (v1.0.0.0)

Thorax

Lung Biomarker Reporting

Current Version
PDF (v1.3.0.2)
Word (v1.3.0.2)
(June 2016^#)
August 2018

Previous Version
2016 (v1.3.0.1)
2015 (v1.2.0.0)

General

DNA Mismatch Repair

Current Version
PDF (v1.0.0.1)
Word (v1.0.0.1)
(January 2018^#)
August 2018

Previous Version
2018 (v1.0.0.0)

CAP Cancer Protocol Usage Limitations and Copyright

The College of American Pathologists (CAP) does not permit reproduction of any substantial portion of these protocols without its written authorization. The CAP hereby authorizes use of these protocols by physicians and other health care providers in reporting on surgical specimens, in teaching, and in carrying out medical research for nonprofit purposes. This authorization does not extend to reproduction or other use of any substantial portion of these protocols for commercial purposes without the written consent of the CAP.

The CAP also authorizes physicians and other health care practitioners to make modified versions of the Protocols solely for their individual use in reporting on surgical specimens for individual patients, teaching, and carrying out medical research for non-profit purposes.

The CAP further authorizes the following uses by physicians and other health care practitioners, in reporting on surgical specimens for individual patients, in teaching, and in carrying out medical research for non-profit purposes: (1) Dictation from the original or modified protocols for the purposes of creating a text-based patient record on paper, or in a word processing document; (2) Copying from the original or modified protocols into a text-based patient record on paper, or in a word processing document; (3) The use of a computerized system for items (1) and (2), provided that the protocol data is stored intact as a single text-based document, and is not stored as multiple discrete data fields.

Other than uses (1), (2), and (3) above, the CAP does not authorize any use of the Protocols in electronic medical records systems, pathology informatics systems, cancer registry computer systems, computerized databases, mappings between coding works, or any computerized system without a written license from the CAP.

Any public dissemination of the original or modified protocols is prohibited without a written license from the CAP.

Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original and primary source for this information is the AJCC Cancer Staging Manual, Eighth Edition (2016) published by Springer Science+Business Media.

The CAP developed these protocols as an educational tool to assist pathologists in the useful reporting of relevant information. It did not issue the protocols for use in litigation, reimbursement, or other contexts. Nevertheless, the CAP recognizes that the protocols might be used by hospitals, attorneys, payers, and others. Indeed, effective January 1, 2004, the Commission on Cancer of the American College of Surgeons mandated the use of the required data elements of the protocols as part of its Cancer Program Standards for Approved Cancer Programs. Therefore, it becomes even more important for pathologists to familiarize themselves with these documents. At the same time, the CAP cautions that use of the protocols other than for their intended educational purpose may involve additional considerations that are beyond the scope of this document.

The inclusion of a product name or service in a CAP publication should not be construed as an endorsement of such product or service, nor is failure to include the name of a product or service to be construed as disapproval.

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