The role of CAP in standardisation of pathology practice, including our laboratory accreditation program, predictive markers (HER2, ER, PR) and pathology report standardisation

Abstract

Proficiency testing: The College of American Pathologists (CAP) Surveys Program began in 1949, two years after the founding of the College and the first Board initiative to establish a national proficiency testing program. The program was very well received by the US laboratory community and since that time the numbers of laboratories and product offerings have grown steadily. Currently 25000 laboratories are enrolled and test for approximately 1000 analytes. The Surveys Program is primarily peer group based, however, there are considerable educational efforts devoted to establishing best practices to encourage harmonisation in the field. Harmonisation is roughly defined as a narrowing of variability for tests. Proficiency testing in anatomic pathology was initiated in 1990 for gynaecological cytopathology and will soon be rolled out for HER2, ER and PR. Laboratory Accreditation Program (LAP): The CAP is unique in laboratory accreditation services utilising peer review for the vast majority of inspections. This assures that the inspectors are up to date and also ‘in the trenches’ in modern laboratory practice. The requirements of CAP’s LAP program are the most stringent in the industry and are recognised widely as the gold standard. Currently, the CAP certifies over 6500 laboratories in the USA and worldwide. Standardisation of practice and reporting: The first foray of the CAP into standardised reporting came with the development by CAP of the cancer protocols in 1986. These protocols and checklists have become the gold standard in cancer reporting and are now required by the American College of Surgeons (USA) and the American Joint Commission on Cancer (AJCC) for accredited cancer programs. Recently, the CAP has or will publish (in Archives of Pathology and Laboratory Medicine) guidelines for pathology reporting in areas of molecular pathology, surgical pathology and non-gynaecological cytopathology.