Cancer Protocol Templates

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

The CAP Biomarker Reporting Protocols are intended to provide reporting guidance for commonly ordered biomarkers and are not required for accreditation purposes.

April 2021

Paperback Option for AJCC Cancer Staging System: Cervix Uteri Protocol Version 9

The American Joint Committee on Cancer (AJCC) received important feedback from the College of American Pathologists and our members as well as cancer registry and clinical communities regarding the AJCC Cancer Staging System: Cervix Uteri Protocol (Version 9), released as an eBook in October 2020. AJCC learned from users that the Version 9 eBook format was not sufficient and they wanted the information in print form as institutional firewalls was blocking the content, in many instances. AJCC is still evaluating all options for disseminating AJCC content and recently announced that a paperback version of AJCC Cancer Staging System: Cervix Uteri Protocol (Version 9) is now available for purchase on Amazon for $9.99. Learn more

October 2020

The College of American Pathologists October 28, 2020 Uterine Cervix release includes 2 revised cancer protocols. Highlights include:

• Addition of “Equivocal” to Lymphovascular Invasion
• Margins Section modifications
• Addition of a separate Distant Metastasis section
• Revisions to the Lymph Node Section (driven by new AJCC pN Staging Classification)
• Updates to AJCC 9th Version pTNM Staging Classification including alternate verbiage in lieu of pTX and pNX as approved by AJCC
• Updates to include FIGO 2018 Staging Corrigendum (for more information, see https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.12969)
• Updates to Explanatory Notes for Histologic Type, Silva Pattern, Lymphovascular Invasion
• General formatting changes
• Public Comments received are available.

The AJCC has set an implementation date of January 1, 2021 for use of the 9th Version of its Uterine Cervix cancer staging system. Users should ensure that they update their cancer reporting systems for the Uterine Cervix Resection protocol prior to the January 1, 2021 implementation date.

April 2020

The College of American Pathologists April 2020 agile release includes 3 revised cancer protocols. Highlights include:

• Changed conditional questions in Margins section of Anus Excision protocol to non-core (optional) elements.
• Required status of certain elements in the Melanoma of the Skin: Excision, Re-excision and Biopsy protocols Margins sections were changed from conditionally reported to non-core (optional).

March 2020

• Effective March 9, 2020 version 4.1.0.0 of the Prostate, Resection protocol has been removed and replaced with version 4.1.0.1 to correct a typographical error in Explanatory Note C.

February 2020

The College of American Pathologists February 2020 release includes 47 revised cancer protocols and one new adult Autopsy reporting protocol.

• The Gastrointestinal and Breast protocols have been updated to reflect the revised WHO histologic types.
• Colon protocol has been updated requiring reporting of Macroscopic Evaluation of Mesorectum.
• Breast Biomarker reporting has been harmonized with the latest release of the ASCO - CAP Practice Guideline Update.
• The CAP continues to separate the protocols to offer unique documents for biopsy, resection, or other separate procedure for easier use of the templates and for better understanding of their requirements for accreditation purposes.
• Most of the revisions are minor including formatting, minor corrections, or explanatory notes clarifications.
• The eCC corresponding release includes 87 templates.
• Public comments received are available.

• 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.
• February 2020 news release.

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

© 2020 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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