Pathology reporting of rectal cancer: a national audit

To audit the quality and completeness of histopathology reports of rectal cancer resections submitted to the National Cancer Registry in 2000.

All 388 mid- and low-rectal-cancer specimen reports submitted to the Registry were reviewed. Reports were scored according to a pre-defined 'proforma' as to the completeness of the pathological examination and the submitted report.

Scores from teaching hospitals, public non-teaching hospitals and private laboratories did not differ significantly. Multiple staging systems were used in 40% of reports and no stage was allocated in 31% of reports. Circumferential margin involvement was recorded in 63% of reports.

No significant differences exist in the quality of pathology reporting of rectal cancer between different laboratory types, either public or private. There is a lack of uniform reporting of rectal cancer stage, with multiple staging systems in use. Circumferential margin involvement is frequently omitted in spite of its documented value as an indicator of quality of rectal cancer surgery, as an important predictor of local recurrence, and its more-recently established value as a marker for distant metastasis and survival.