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
Central Nervous System
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
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
Breast
CNS
Endocrine
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
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
Thorax
General
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.