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AUGUST 2017 | Published by RCPA

Issue #072

New and improved structured reporting of lung cancer

New and improved structured reporting of lung cancer

It isn’t only the diagnosis and treatment of lung cancer that has changed over the years. The way it is reported by pathologists has also been put under the microscope, and the result is a more effective process. We asked Dr Jenny Ma Wyatt, Anatomical Pathologist at SA Pathology, a few questions about this change.

When was structured reporting for lung cancer developed and why?

In June 2007, a National Round Table was held to discuss the use of structured reporting of cancer throughout Australia. All who were present at the Round Table agreed that structured reporting of cancer cases in anatomical pathology and haematology is likely to contribute to better cancer control through improvements in:

(1) clinical management and treatment planning
(2) cancer notification, registration and aggregated analyses
(3) research.

The Cancer Institute NSW secured funding in February 2008 from the then Department of Health and Ageing (Quality Use of Pathology Program) to work with the RCPA and Cancer Australia to develop six initial reporting protocols (lung, melanoma, breast, colorectal, lymphoma and prostate) and a framework to guide development of the protocols, in partnership with national clinician and pathologist organisations. The protocols contain guidelines for the preparation of structured reports for the specimens of cancers.

The first edition of the Lung Cancer protocol was published in February 2010. It was developed by an expert committee that included pathologists, surgeons and oncologists. I have been the Chair and lead author of the protocol since that time.

Why is a structured report useful?

An anatomical pathology report contains information, including the diagnosis, that a clinician uses to plan their patient’s treatment. When the report is written in prose form, it takes time for the clinician to go through it and find the points that are particularly important for each individual case. In a structured report, the information is set out in a systematic manner in point form under headings so that the clinician can access the required information more readily. A structured report also helps to ensure all the important information is included in the report. In other words, all the important information is included in a readily accessible format.

How has structured reporting changed the diagnosis and management of lung cancer?

Lung cancer resection specimens are now usually reported in a structured reporting format. By improving the completeness and usability of pathology reports for clinicians, structured reporting has contributed to better cancer control through improvements in clinical management and treatment planning.

How is new evidence related to lung cancer integrated into the reporting protocol?

The protocol is updated with new editions that incorporate new evidence. The second edition was published in 2013, and we will be doing the third edition in the very near future.




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