College of American Pathologists (CAP) PERT Update

A CAP PERT meeting was held in Las Vegas on Thursday, October 17, followed by a Cancer Data Summit held on Friday, October 18, 2024, both of which preceded the CAP Annual Meeting. Highlights of the PERT meeting included:

• 2024 Protocol Release – Quarter 4 Release is scheduled for December 11, 2024, and will include nine protocols including Lung (AJCC 9), Thymus (AJCC 9), Mesothelioma (AJCC 9), Pharynx (AJCC 9 for Nasopharynx elements), Cutaneous Head and Neck Squamous Cell Carcinoma, Endometrium (FIGO), Gyn Biomarker, Urethra Resection (Tumor Extent question needs to be updated), and Urethra Biopsy (Tumor Extent question needs to be updated).

Upcoming release dates are scheduled for:

• Quarter 1: March 19, 2025
• Quarter 2: June 18, 2025
• Quarter 3: September 17, 2025
• Quarter 4: December 17, 2025

Other updates and all the CAP Cancer Protocols can be found on the CAP Website: Cancer Protocol Templates | College of American Pathologists (cap.org)

• eCP to SNOMED Mapping Project – Dr. Scott Campbell, University of Nebraska, provided an update on this project, which is nearing completion. The final fifteen protocols were sent to Dr. Campbell for final validation after review by the CAP team.
• USCDI – Sandy Jones, CDC Liaison to PERT, provided an overview of USCDI+. Dr. Veronica Klepeis, PERT Chair, shared that consideration of an “AP report” including 23 proposed data elements was submitted during the period for public comment. Further discussion ensued among the PERT meeting attendees with a suggestion to explore ways to support Cancer Registries and demonstrate the value and use of eCP data.
• ICD-O – Dr. Keluo Yao, PERT Vice-Chair, presented a question to PERT regarding the best use of ICD-O in eCPs. Further discussion revolved around the pathology community taking a more active role in utilizing this coding system for cancer statistics, how best to report findings back to clinicians, and coordinating with hospital registries to integrate this data into their systems. Dr. Campbell then gave an overview of his current project reviewing the ICD0-4 to SNOMED transition.

Cancer Data Summit 

This year’s summit, The Future of Cancer Data: Harnessing the Power of Pathology Data, was held in Las Vegas on October 18. Speakers ranged from an oncologist who is also a cancer survivor, Mark Lewis, MD, Director of GI Oncology, Intermountain Healthcare, Utah to Alison Van Dyke, MD, PhD, Medical Officer, NCI.

In Dr. Lewis’ presentation, “The Oncologist Without the Pathologist is Blind: The Dual Perspective of a Patient-Physician,” Lewis captivated us with his perspective of the cancer journey through the eyes of a patient (himself) as well as his father and grandfather and the strong impact of pathology data on personalized treatment and improved long term outcomes for cancer patients.

During, “It’s All About the Data: Perspectives on Structured Data Across the Cancer Patient Continuum,” Dr. Jeffrey Gershenwald, MD Anderson Cancer Center, shared how the CAP’s approach to synoptic reporting informed strategies for the recently deployed AJCC Cancer Staging Protocols and the American College of Surgeons Cancer Surgery Standards Program (CSSP).

Paul Seegers, Senior Advisor & Administrator of the Palga Foundation (a nationwide network and registry of histo- and cytopathology in the Netherlands), in his talk, “Standardized Structured Reporting in Pathology: An Overview and Future Perspectives,” described the seven levels of pathology reporting (from Narrative as #1 to Semantic Interoperability with SNOMED as #7), and how the Netherlands and specifically the Palga Foundation is moving forward with Standardized Structured Reporting (Synoptic Reporting) including the use of Digital Pathology and AI to help improve patient outcomes.

Other presentations included, “Integrating Pathology Data: Enhancing Patient Care and Quality Improvement,” a panel discussion moderated by Dr. Michael Berman, formerly of Jefferson Hospital, with presenters: Dr. Mary Edgerton, University of Nebraska Medical Center, Dr. Veronica Klepeis, Massachusetts General Hospital and Harvard Medical School, and Aaron Pollett, Ontario Health, each of whom shared their respective experiences with cancer data integration and how it can advance medical care and research;

“Charting the Patient Journey: Enhancing Outcomes Through Patient-Centered Digital Pathology,” by Dr. John Groth, Endeavor Health, shared the current state of communication between pathologist and patient and highlighted the impact of standardized digital pathology on patient outcomes;

“Interoperability Data Standards and Their Impact on The Future of Cancer Diagnostics,” a panel discussion moderated by Eric Daley, CAP, with presenters: Sandy Jones, Public Health Advisor, CDC, Alex Goel, CEO & Founder of Topology Health, and Scott Campbell, PhD, MBA, University of Nebraska Medical Center, shared their visions for cancer surveillance reporting in five years, the flow of cancer data, and how their facility is using SNOMED respectively;

“Pathology Report to Cancer Research: Ensuring Data Quality in the AI Era,” by Dr. Alison Van Dyke, NCI, who presented an overview of cancer surveillance systems and data acquisition, how CAP is improving the foundation of cancer surveillance data quality, and the future of cancer surveillance data capture reporting.

Other CAP Resources:

CAP Podcasts, also called CAPcasts, have several sessions of interest specific to the cancer registry community. A small sampling of sessions that might be of interest to you:

• July 5, 2024: Melanoma and Skin Cancer Awareness (including what’s on the horizon for new biomarkers)
• August 30, 2024: Navigating Familial Cancers: What Pathologists Need to Know to Diagnose MEN1 (One of the presenters on this podcast is Dr. Mark Lewis, a presenter at the Cancer Data Summit, talking about his own diagnosis – see more under the Cancer Data Summit above).
• September 27, 2024: A Healthy Discussion on Renaming Low-Grade Prostate Cancer as Non-Cancer

They can be found here: https://podcasts.apple.com/us/podcast/capcast-from-the-college-of-american-pathologists/id1279391140

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