An audit of colorectal cancer reports in a Sri Lankan tertiary care setting

Abstract

Introduction: Histopathology reports of colorectal cancer describe essential histopathological factors that influence the treatment and prognosis of colorectal cancer. Incomplete reports can convey misleading information resulting in improper or inadequate management. Objective: To audit the content of histopathology reports of colorectal cancer in a single tertiary care centre and compare findings with a similar audit done in 2000. Method: Histopathology reports of 134 patients with colorectal cancer, from January 2002 to October 2006, from the department histopathology of the Sri Jayewardenepura University, were evaluated using the minimum dataset for colorectal cancer reporting required for proper patient management of the Royal College of Pathologists of UK and the College of Pathologists of Sri Lanka. Results were compared with a previous audit done in Sri Lanka (Hewavisenthi et al, 2000). Results: The majority of data items were mentioned in more than 75% of the reports in the current and previous (2000) audit. The minimum data items were mentioned more frequently in this audit than in the 2000 study. Three items namely TNM stage, involvement of circumferential margin and relationship of tumour to the peritoneal reflection were poorly mentioned in both audits. Total number of lymph nodes and lymphovascular invasion were mentioned more often in the current audit. Conclusion: The quality and completeness of histopathology reports has improved with time. Data Items that were mentioned in more than 75% reports in the 2000 audit were mentioned in more than 90% in the current audit. However data items such as TNM staging, circumferential margin involvement and relationship to the peritoneal reflection are frequently omitted in both. It is recommended that a proforma containing minimum data variables be used for reporting colorectal cancer to rectify these omissions and the results evaluated.