Establishing Synoptic Cancer Pathology Reporting in Low- and Middle-Income Countries: A Nicaraguan Experience

Cancer pathology reports have traditionally been narrative with limited reliable information. In high-income countries, synoptic format reporting has gradually been introduced to improve patient care and cancer registry input. We posited that introduction of synoptic style reporting was possible in Nicaragua and could serve as a model for other low- and middle-income countries.

The Department of Pathology, Hospital Escuela Oscar Danilo Rosales Argüello (HEODRA), León, Nicaragua, decided to introduce and implement synoptic reporting for all cancer cases beginning in 2018. All 10,012 histopathologic case reports issued by the department from January 1, 2018, through June 30, 2020, were reviewed. After excluding benign lesions, recurrent or metastatic tumors, endometrial biopsies or curettage, and primary cytologic specimens, 724 cases met the criteria for synoptic style reporting. The narrative format, previously used for all cases, was intentionally abandoned.

Of the 10,012 reports reviewed at HEODRA during the study period, synoptic-style reporting was used for all 724 cancer cases that met criteria for inclusion in the study. In addition, all elements were listed in the required order. Narrative format of reporting was not used for any of the reports.

Our experience in Nicaragua has shown that establishing synoptic-style cancer pathology reporting is achievable in a low- or middle-income country. Just as in high-income countries, a dedicated collaborative step-by-step conversion to synoptic reporting can lead to improvement in cancer patient care and quality of data for population-based registries.