Gail H. Vance, MD
Swikrity U. Baskota, MD
Julia Rankenburg
November 2024—Members of the CAP Foundation Global Pathology Committee and the CAP Cancer Committee collaborated to develop a three-part webinar series on how to use the CAP cancer protocols. The webinars were directed to international pathologists, particularly those in low- and middle-income countries.
The CAP cancer protocols are available worldwide in PDF and Word formats and are free to download for use in standardizing cancer reporting. In conversations with pathologists from low- and middle-income countries and other global pathology organizations, the foundation’s Global Pathology Committee learned that although practicing pathologists in these areas have access to the cancer protocols, they may not necessarily know how to use them.
A workgroup was formed to develop and implement a three-part webinar series designed to help pathologists integrate the CAP cancer protocols into daily practice. While low-resource countries may have infrastructure limitations, most have internet access.
The workgroup consisted of members of the Global Pathology and Cancer committees, who met monthly to discuss the webinar content. To better understand if this idea was supported in the global pathology community and to aid in content development, an informal focus group survey was released via social media targeting pathologists worldwide. Findings revealed that most of the approximately 160 respondents (87 percent) use the CAP cancer protocols, four percent use the International Collaboration on Cancer Reporting (ICCR) protocols, and eight percent use another form as their standardized cancer reporting template.
The workgroup and CAP marketing staff released a second survey in March 2023 to determine the level of awareness, knowledge, and use of the CAP cancer protocols, and the 268 responses represented 41 countries. In this survey, 70 percent of respondents reported using the CAP cancer protocols and indicated a high level of satisfaction with them. Twenty-five percent used either an internally developed protocol or no standardized cancer reporting protocol. When asked why a standardized reporting protocol was not used, respondents said the practice did not require the use of protocols, cost was a barrier, or pathologists were not trained to use a protocol or didn’t have time to implement.
More than 90 percent of survey respondents were interested in learning more about the CAP cancer protocols in a free webinar series. Respondents in East Asia and the Pacific, sub-Saharan Africa, and South and Central Asia expressed the most interest. Pathologists who were newer in practice had higher interest levels than more experienced pathologists.
Shaped by the responses to both surveys, the webinar series had six content areas: what the CAP cancer protocols are, how they are developed, what the value is of using them (why it’s worth the effort), how pathologists can use the protocols with their available resources, what the required versus nonrequired data elements are, and the availability and utility of notes in the CAP cancer protocols.
The presenters of the webinars were faculty who are familiar with the challenges of using the CAP cancer protocols in under-resourced environments. They offered strategies to overcome hurdles and information to improve the diagnostic skills of attendees. Each live webinar session consisted of a 50-minute presentation (in English) and 10 minutes of questions and answers, with all webinar questions answered live during the webinar or in writing later. The webinar recordings and responses to questions are available at https://bit.ly/CAPcancerproto.
Responses to brief surveys after each webinar consisted of high ratings for presenters and content and an increased level of knowledge, understanding, and use of the protocols.
In addition, a summation post-webinar series survey was sent to those who attended one or more live webinars and to those who listened to one or more recordings to gather feedback to determine if the project goals had been achieved and to learn of the interest in future CAP Foundation Global Pathology Committee projects. The response rate was 17 percent (156 responded, 111 of whom attended live). Ninety-seven percent expressed overall satisfaction with the webinar series. Rated highest were the speakers’ knowledge/expertise, the relevance of the topics/content, and the level of information presented. The area that received a comparatively lower score was “keeping you engaged throughout the webinar.”
The top valued aspects of the webinar series to attendees and their practice were the quality of the content, the ability to apply what they learned to their clinical practice, the expertise of the presenters, and the expansion in knowledge through exploration of areas of pathology with which the participant was previously unfamiliar.
Eighty-five percent of post-webinar survey respondents said they are currently using the CAP cancer protocols. Seventeen percent use the ICCR templates, and five percent use internal/practice-developed protocols.
Seventy-three percent of post-webinar survey respondents plan to increase their use of the CAP cancer protocols. Of those not using them, 59 percent plan to implement/use them within the next year. Only 12 percent do not plan to implement the protocols in their practice.
Ninety-two percent are “very” interested in attending additional CAP cancer protocol webinars. The top topics of interest: biomarkers, head and neck, bone and soft tissue, ovary, and endometrium.
Dr. Vance is chair and Dr. Baskota is a member of the CAP Foundation Global Pathology Committee. Dr. Baskota is a CAP Foundation board director and Dr. Vance is a former board director. Dr. Vance is Sutphin professor of cancer genetics, emeritus; professor emeritus, medical and molecular genetics; and professor emeritus, pathology and laboratory medicine, Indiana University School of Medicine. Dr. Baskota is assistant professor, Department of Pathology and Laboratory Medicine, University of California-Davis, Sacramento. Julia Rankenburg is senior manager, program and fund administration, CAP Foundation (foundation.cap.org). The Global Pathology Committee invites suggestions for future projects and initiatives; send them to capfdn@cap.org.