| Sumario: | * Context.--Quality communication between clinicians and pathologists is required for optimal cancer care. The College of American Pathologists provides anatomic site--specific cancer protocols that facilitate synoptic reporting for efficient communication, contributing to accuracy and completeness of cancer staging. Objective.--To evaluate synoptic cancer pathology reporting across the Department of Veterans Affairs (VA), the largest integrated health system in the United States, for 4 common cancers: melanoma and colon, bladder, and kidney cancer. Design.--For each cancer type, we investigated at least 200 biopsy and 200 resection reports from 2019 to 2021. In each report, we determined whether a synoptic format was used. The reports were selected using random sampling across all VA health care facilities. We also identified a set of core elements that were underdocumented. Results.--Among 1618 pathology reports, 778 (48%; 95% CI, 46%--50%) were synoptic reports. Synoptic reporting was much more common among resections (621 of 811; 77%; 95% CI, 74%--79%) than among biopsies (157 of 807; 19%; 95% CI, 17%--22%). It was most common in colorectal resections (200 of 206; 97%; 95% CI, 94%--99%) and least common in colon biopsy reports (1 of 200; 0.5%; 95% CI, 0%--3%). Core elements that were underdocumented included procedure and regional lymph nodes for resections of bladder and kidney cancer and of melanoma. Conclusions.--Synoptic reporting was used about three-quarters of the time for resections and about 1 in 5 times for biopsies. Future work should develop implementation strategies to improve synoptic reporting, especially for biopsy specimens and core elements that were relatively underdocumented.
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