Clinical Scorecard: Preparing Pathology for Rising Cancer Diagnostic Volumes

At a Glance

Key Highlights

• The article reports that US cancer diagnoses are expected to exceed 2 million annually.
• Earlier detection may bring more subtle or borderline lesions into the diagnostic pathway, increasing specimen volumes and complex workups.
• The interviewee says laboratories should design and validate the workflow around a test, not only the assay.
• Digital pathology could allow specialist consultation and distributed case review across locations and time zones.
• The interviewee describes AI as supporting pathologists’ judgment; specimen quality, patient history, and prior therapies still require professional interpretation.

Guideline-Based Recommendations

Diagnosis

• The interviewee describes combining morphology with molecular profiling, germline testing, other investigations, and relevant clinical information.
• Present combined findings in a clear, accessible report that oncologists can use when discussing care with patients.

Management

• Plan workflows for ordering, specimen collection, analysis, reporting, electronic medical record integration, and clinical interpretation when introducing tests.
• Determine the order and combination of tests when biopsies provide limited tissue.
• The interviewee identifies automation, digital case management, and interoperability between systems as increasingly important.

Monitoring & Follow-up

• Assess turnaround time across the diagnostic pathway, including order, result delivery, and clinician access.
• The source reports oncologists’ concern about turnaround time; it does not state a formal recommendation to ensure reports are readily interpretable in electronic medical records.

Risks

• Increasing case volumes and complex diagnostic workups may add to pathologists’ workloads.
• Limited tissue from smaller lesions and biopsies may constrain testing choices.
• Delays can occur when information is incomplete, cases are placed on hold, or reports are difficult for clinicians to find in electronic medical records.
• The article identifies cost, reimbursement, and system integration as challenges or barriers to introducing new diagnostics.

Patient & Prescribing Data

Patients entering the cancer diagnostic pathway, including some whose earlier evaluation identifies subtle or borderline lesions.

The article does not provide prescribing or treatment regimens. It states that diagnostic reports should give oncologists clear findings to use when discussing care with patients.

Clinical Best Practices

• The interviewee says laboratories should validate the supporting workflow as well as the diagnostic assay.
• Use tissue stewardship to guide test selection and sequencing when biopsy material is limited.
• Digital pathology could enable cases to be shared with relevant specialists regardless of location.
• The interviewee describes integrating image-based, genomic, and clinical information while retaining professional interpretation.
• Assess turnaround time across the diagnostic pathway; the source reports oncologists’ concern about turnaround time but does not prescribe a specific measurement method.

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