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Cancer Protocol Templates

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.

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

© 2018 College of American Pathologists (CAP). All rights reserved.

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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