Cancer Protocol Templates

• 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.
• Download the current summary of revisions.
• Download the summary of required elements.
• Provide your feedback about the CAP cancer protocols to cprotoc@cap.org.
• June 2021 news release.

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

June 2022 CAP Cancer Protocol Update: Clarifications

• Anus and Appendix templates. While these updates include American Joint Committee on Cancer (AJCC) 9th version content, pathologists may continue to use the previous AJCC 8th version tumor stage classification system for cancer reporting until the updated content is required for use on January 1, 2023. The CAP released the updated cancer protocols ahead of the release of the 9th version staging system to allow organizations and laboratory information system (LIS) vendors sufficient time to make changes in their systems reflecting these updates.
• Protocol for Cutaneous Squamous Cell Carcinoma of the Head and Neck. This protocol is required for accreditation.

Previous Updates

On June 22, 2022, the College of American Pathologists released updates to 12 CAP Cancer Protocols. All changes are outlined in the Summary of Revisions.

New Cancer Reporting Protocol:

• Protocol for Cutaneous Squamous Cell Carcinoma of the Head and Neck

Changes affecting accreditation date:

• Anus and Appendix templates were updated to include AJCC 9th version content
• Added answers under Histologic Type to include Squamous Cell Carcinoma grading in the Major Salivary Gland template
• Deleted Tumor Modifier question and combined answer list with TNM Descriptors question for the Endometrium template
• Deprecated Hepatoblastoma from the Histologic Type answers in the Hepatocellular Carcinoma template
• Changed Distance from Invasive Carcinoma to Closest Margin from optional to core in the Lung template
• Updated the pN3a staging classification in the Breast Invasive template

Other key content changes include:

• Updated pN0 staging classification in the Breast Phyllodes template
• Changed the HER2 ISH question to conditional from optional, changed the Ki-67 question to core from optional, and deprecated the Multiparametric Gene Expression question in the Breast Biomarker template

All changes are outlined in the Summary of Revisions [under Resources]. Provide your feedback about the CAP cancer protocols to cprotoc@cap.org.

The College of American Pathologists March 2022 release updated 19 CAP Cancer Protocols.

Highlights of these content changes include:

• NEW Protocol – Phyllodes Tumor of the Breast
• All Pediatric Biopsy and Resection Protocols have an added question for Expert Consultation; for Wilms Tumor resection, this change affects the accreditation date
• Deprecated the Distance from Tumor to Vascular, Ureteral, and Soft Tissue Margin Questions for Wilms Tumor Resection: this change affects the accreditation date
• Lymphovascular Invasion was changed from an optional to a core element in the Breast Invasive Resection template which affects the accreditation date
• Clarified Number of Isolated Tumor Cells in the Uterine Sarcoma Resection template which affects the accreditation date
• Other minor content changes include explanatory note updates, corrections of typographical errors, and clarification of answer choices for peritoneal ascitic fluid

All changes are outlined in the Summary of Revisions [under Resources]

The College of American Pathologists November 2021 release updated 19 CAP Cancer Protocols. Highlights of these content changes include:

• Changed the name of the Lip and Oral Cavity to Oral Cavity to update scope of the protocol
• Added ITC reporting question and answer set to Regional Lymph Nodes in Uterus Sarcoma – will affect accreditation date
• Changed nested Margin questions from Conditional to Required and Remodeled Preexisting pleomorphic adenoma component question in Head and Neck Protocols
• Updated Not Applicable statement to state "invasive melanoma" vs "invasive carcinoma" and cover page to qualify use for Invasive Melanoma Excision
• Added a new, repeating section for other user entered biomarkers in Quantitative IHC Biomarker Reporting
• Updated instructional and explanatory notes
• Reformatted Questions and Answers, and reporting order of elements

There are no new or retired protocols in this release. Additionally, there were 13 protocols that underwent technical changes only to their corresponding CAP eCC template. Although these protocols did not have any content changes, they received new version numbers to reconcile our database.

All changes are outlined in the Summary of Revisions [under Resources]