Cancer Protocol Templates

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]

We have scheduled a November 2021 a CAP Cancer Protocols release. It will include content changes to 11 CAP Cancer Protocols. There will be additional metadata changes to 16 CAP electronic Cancer Checklists (CAP eCC) templates. 

We will detail all changes in the release documentation and on this page once released.

The WHO Classification of Tumours editorial board recently started writing the Haematolymphoid tumours volume. In an attempt to engage the community further, and in line with International Agency for Research on Cancer’s open science policy, WHO has published for the first time the draft classification for the Haematolymphoid volume with a dedicated email address for comments and suggestions on content to haematolymphoidtumours@iarc.fr. Haematopathologists, haematologists, oncologists, geneticists, molecular pathologists, other cancer specialists, and patient representative are serving as experts. Please submit feedback by October 15, 2021.

• Skin, Melanoma, Biopsy v4.3.0.1 – Updated August 17, 2021
  • Updated formatting and added instructional note to better differentiate in situ vs. invasive reporting elements ^*
• Skin, Melanoma, Resection v4.3.0.1 – Updated August 17, 2021
  • Updated formatting and added instructional note to better differentiate in situ vs. invasive reporting elements ^*
• Ovary, Fallopian Tube, Peritoneum v1.3.0.0 – Updated August 11, 2021
  • Corrected staging classifications for pT1a and pT1b

* These are navigational notes for the Cancer Paper Protocols only not for the electronic Cancer Checklist

• Bone, Resection Protocol v4.1.1.0 – Updated July 28, 2021
  • Fixed incorrect staging classification for pT1 under pT Category for Appendicular Skeleton, Trunk, Skull, and Facial Bones
  • Fixed incorrect staging classification for pT1a under pT Category for Pelvis
• Pancreas (Exocrine) Protocol v4.2.0.1 – Updated July 28, 2021
  • Fixed incorrect staging classification note for pT1
  • Fixed incorrect staging classification for pT2
• Vulva Protocol v4.2.0.1 – Updated July 28, 2021
  • Fixed incorrect staging classification note for pN2
• Lip and Oral Cavity Protocol v4.1.0.1 – Updated July 28, 2021
  • Fixed error in All Carcinomas - pT Category - pT1
  • Fixed error in All Carcinomas - pT Category - pT4a
• Stomach Resection Protocol v4.2.1.0 – Updated July 27, 2021
  • Added back "pM1: Distant metastasis" Answer
• Uterine Cervix Resection Protocol v5.0.1.1 – Updated July 16, 2021
  • Added “Other (specify)” as answer options to Para-aortic Lymph Node questions

The College of American Pathologists (CAP) June 2021 release of the updated CAP Cancer Protocols, includes 87 revised and three new cancer protocols.

Highlights of the changes in this release include:

• New WHO histologic codes for the Bone / Soft Tissue, Gynecologic, and Thorax protocols
• Removed pTX and pNX staging
• Added new Distant Metastasis sections
• Updated modeling standard for margin sections across all protocols
• Updated modeling standard for lymph node sections across all protocols
• Protocol format standardization resulting from new authoring process
• Replaced all symbols (<,>,<=,>=) with actual words less than, greater than, etc.

Along with the above noted changes, we also released three NEW Cancer Reporting Protocols.

• Prostate Needle Biopsy (Case Level) Protocol
• Prostate Needle Biopsy (Specimen Level) Protocol
• Quantitative IHC Reporting Protocol

Notes: None of the new protocols are required for Accreditation and no Cancer Protocols have been retired in this release.

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

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.

• 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.