Introduction Surgical pathology depends heavily on the input of clinicians and surgeons. The pathologist’s need for adequate clinical information before diagnosis can be made has been highlighted in the past. According to the Royal College of Pathologists’ guidelines for reporting colorectal cancer, histopathology requests need (1) a diagram of the surgical procedure, (2) if the cancer has been detected as part of the bowel cancer screening programme, (3) the histological type of tumour if known, (4) a history of inflammatory bowel disease/ familial cancer, (5) the pre-operative stage of tumour, (6) any pre-operative therapy has been given, when it finished and its nature, (7) if open, laparoscopic or robotic surgery has been performed, the type and dissection plane of the operation. We aimed to audit the quality of clinical information provided in colorectal cancer resection histology requests for the past 5 years in our hospital.

Method Data was collected for 500 patients with large bowel cancer resections between 2/12/2009 and 18/11/2014

Results Of 498 histology request forms, only two had a diagram present (0.4%) and three (0.6%) reported that the tumour was detected in the bowel cancer screening programme. The histological type was reported in 72 out of 496 samples (14.52%) and the presence of IBD or familial cancer was reported in 2 out of 497(0.4%). The pre-operative stage of tumour was recorded in 27 out of 496 reports (5.4%) and the pre-operative therapy given in 56 out of 496(11.3%). Finally, the type of surgery and dissection were adequately documented in 221 out of 497 reports (44.5%).

Conclusion Overall, the quality of reporting of clinical information in histology reports remains suboptimal. This audit identified important areas in which reporting quality needs to be improved.

Disclosure of interest None Declared.

References

1. Dataset for colorectal cancer histopathology reports July 2014, Royal College of Pathologists guidelines

2. Are clinicians failing to supply adequate information when requesting a histopathological investigation? J Clin Pathol. 2001;54(10):806