| Ontario Health - Cancer Care Ontario's Data Book - 2024-2025 |
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Updated December 2023
The College of American Pathologists (CAP) electronic Cancer Checklists (eCC) are a standardized list of common Question/Answer pairs used in reporting cancer surgical pathology data and were endorsed as a national standard by the Canadian Association of Pathologists on July 14, 2009. As of fiscal year 2010/11, CCO began implementing the CAP electronic Cancer Checklist standard with hospitals across the province. Now that all participating hospitals have completed implementation, the latest CAP eCC release is mandated across Ontario. The list of mandated CAP Cancer Checklists and Effective dates can be found in Appendix 4.1.
To date, CCO Pathology Laboratory Medicine Program mandated use of 6 CAP biomarker templates; which became available in the October 2013 (Lung & CRC), December 2013 (Breast), June 2014 (Gastric HER2), July 2015 (Melanoma Biomarker Template), and July 2016 (Endometrium: Biomarker Reporting Template).
| Body System | Mandated electronic Cancer Checklist (eCC) | CAP Template ID | Accepted eCC Release Versions | CAP original Release Date | OH Effective Date |
| Bone and Soft Tissue | BONE: Resection | 138.1000043 | 3.004.021 | Mar-22 | Apr-23 |
| SOFT TISSUE: Resection | 168.1000043 | 3.004.021 | Mar-22 | Apr-23 | |
| Breast | DCIS OF THE BREAST: Biopsy | 360.1000043 | 1.002.001 | Jun-21 | Apr-22 |
| DCIS OF THE BREAST | 211.1000043 | 3.003.021 | Mar-22 | Apr-23 | |
| INVASIVE CARCINOMA OF THE BREAST: Biopsy | 362.1000043 | 1.004.001 | Sep-23 | Apr-24 | |
| INVASIVE CARCINOMA OR THE BREAST | 189.1000043 | 4.009.011 | Sep-23 | Apr-24 | |
| PHYLLODES OF THE BREAST: Resection | 547.1000043 | 1.001.011 | Sep-23 | Apr-23 | |
|
Central Nervous System |
CENTRAL NERVOUS SYSTEM | 551.1000043 | 1.000.000 | Sep-22 | Apr-23 |
| Gastrointestinal | AMPULLA OF VATER: Ampullectomy, Pancreaticoduodenectomy (Whipple Resection) | 131.1000043 | 3.004.001 | Jun-21 | Apr-22 |
| ANUS: Abdominoperineal Resection | 134.1000043 | 4.000.001 | Jun-22 | Apr-23 | |
| APPENDIX, NEUROENDOCRINE TUMOR (CARCINOID TUMORS): Excision (Appendectomy) or Resection | 193.1000043 | 2.002.021 | Mar-22 | Apr-23 | |
| APPENDIX: Resection (Appendectomy with or without right hemicolectomy) | 135.1000043 | 4.001.001 | Sep-23 | Apr-24 | |
| COLON AND RECTUM NEUROENDOCRINE TUMORS (Carcinoid Tumors): Resection, Including Transanal Disk Excision of Rectal Neoplasms | 196.1000043 | 2.002.021 | Jun-22 | Apr-23 | |
| COLON AND RECTUM: Excisional Biopsy (Polypectomy) | 127.1000043 | 2.012.001 | Jun-21 | Apr-22 | |
| COLON AND RECTUM: Resection, Including Transanal Disk Excision of Rectal Neoplasms | 126.1000043 | 3.007.031 | Jun-22 | Apr-23 | |
| DISTAL EXTRAHEPATIC BILE DUCTS: Local or Segmental Resection, Pancreaticoduodenectomy | 142.1000043 | 3.004.001 | Jun-21 | Apr-22 | |
| DUODENUM AND AMPULLA NEUROENDOCRINE TUMOR | 342.1000043 | 1.002.021 | Mar-22 | Apr-23 | |
| ESOPHAGUS: Endoscopic Resection, Esophagectomy, or Esophagogastrectomy | 141.1000043 | 3.003.021 | Jun-22 | Apr-23 | |
| GALLBLADDER: Resection/Cholecystectomy | 144.1000043 | 3.003.011 | Mar-22 | Apr-23 | |
| GASTROINTESTINAL STROMAL TUMOR (GIST): Resection | 145.1000043 | 3.005.001 | Mar-22 | Apr-24 | |
| HEPATOCELLULAR CARCINOMA: Hepatic Resection | 151.1000043 | 3.006.001 | Jun-22 | Apr-23 | |
| INTRAHEPATIC BILE DUCTS: Resection | 194.1000043 | 2.003.011 | Jun-21 | Apr-22 | |
| JEJUNUM AND ILEUM NEUROENDOCRINE TUMOR | 343.1000043 | 1.002.021 | Mar-22 | Apr-23 | |
| PANCREAS (ENDOCRINE): Resection | 156.1000043 | 3.003.021 | Jun-22 | Apr-23 | |
| PANCREAS (EXOCRINE): Resection | 157.1000043 | 3.004.032 | Jun-22 | Apr-23 | |
| PERIHILAR BILE DUCTS: Local or Segmental Resection, Hilar Resection with or without Hepatic Resection | 195.1000043 | 2.004.011 | Jun-21 | Apr-22 | |
| SMALL INTESTINE: Segmental Resection, Pancreaticoduodenectomy (Whipple Resection) | 166.1000043 | 3.003.011 | Mar-22 | Apr-23 | |
| STOMACH, NEUROENDOCRINE TUMORS: Endoscopic Resection, Gastrectomy | 201.1000043 | 2.002.021 | Jun-22 | Apr-23 | |
| STOMACH: Local Resection, Gastrectomy | 170.1000043 | 3.006.001 | Jun-22 | Apr-24 | |
| Genitourinary | ADRENAL GLAND: Needle biopsy (Core, Incisional, Excisional); Resection | 129.1000043 | 3.007.011 | Mar-22 | Apr-24 |
| KIDNEY: Nephrectomy, Partial or Radical | 150.1000043 | 3.004.011 | Mar-22 | Apr-23 | |
| PENIS: Incisional Biopsy, Excisional Biopsy, Partial Penectomy, Total Penectomy, Circumcision | 210.1000043 | 3.004.001 | Sep-23 | Apr-24 | |
| PROSTATE NEEDLE BIOPSY - CASE LEVEL | 507.1000043 | 1.001.001 | Sep-23 | Apr-24 | |
| PROSTATE GLAND: Radical Prostatectomy | 128.1000043 | 3.006.001 | Sep-23 | Apr-24 | |
| RENAL PELVIS AND URETER: Resection | 337.1000043 | 3.005.001 | Sep-23 | Apr-24 | |
| TESTIS: Radical Orchiectomy | 171.1000043 | 3.005.001 | Sep-23 | Apr-24 | |
| TESTIS: Retroperitoneal Lymphadenectomy | 172.1000043 | 3.004.001 | Sep-23 | Apr-24 | |
| URETHRA: Partial or Total Urethrectomy; Cystectomy, Cystoprostatectomy; Anterior Exenteration | 203.1000043 | 3.006.001 | Mar-22 | Apr-23 | |
| URINARY BLADDER: Biopsy and Transurethral Resection of Bladder Tumor (TURBT) | 202.1000043 | 1.007.001 | Sep-23 | Apr-24 | |
| URINARY BLADDER: Cystectomy, Partial, Total, or Radical; Anterior Exenteration | 180.1000043 | 3.004.001 | Sep-23 | Apr-24 | |
| Gynecologic | ENDOMETRIUM: Hysterectomy, With or Without Other Organs or Tissues | 117.1000043 | 3.008.001 | Jun-22 | Apr-24 |
| OVARY or FALLOPIAN TUBE or PRIMARY PERITONEUM | 336.1000043 | 1.007.001 | Aug-21 | Apr-24 | |
| TROPHOBLAST: Dilation and Curettage, Resection | 176.1000043 | 3.002.021 | Jun-21 | Apr-22 | |
| UTERUS (SARCOMA): Hysterectomy & Myomectomy, with or without other organs or Tissues | 216.1000043 | 2.005.001 | Mar-22 | Apr-23 | |
| UTERINE CERVIX: Trachelectomy, Hysterectomy, Pelvic Exenteration | 182.1000043 | 4.004.001 | Jun-22 | Apr-24 | |
| VAGINA: Resection | 186.1000043 | 3.006.031 | Mar-22 | Apr-23 | |
| VULVA | 187.1000043 | 3.004.031 | Mar-22 | Apr-23 | |
| Head and Neck | CUTANEOUS SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK*** | 549.1000043 | 1.000.011 | Sep-22 | Apr-23 |
| LARYNX (SUPRAGLOTTIS, GLOTTIS, SUBGLOTTIS): Incisional Biopsy, Excisional Biopsy, Resection | 205.1000043 | 3.006.001 | Mar-22 | Apr-24 | |
| LIP AND ORAL CAVITY: Incisional Biopsy, Excisional Biopsy, Resection | 206.1000043 | 3.008.001 | Mar-22 | Apr-24 | |
| MAJOR SALIVARY GLANDS: Incisional biopsy, Excisional Biopsy, Resection | 152.1000043 | 3.007.001 | Jun-22 | Apr-24 | |
| NASAL CAVITY AND PARANASAL SINUSES: Incisional Biopsy, Excisional Biopsy, Resection | 207.1000043 | 3.006.001 | Mar-22 | Apr-24 | |
| PHARYNX (OROPHARYNX, HYPOPHARYNX, NASOPHARYNX): Incisional Biopsy , Excisional Biopsy, Resection | 208.1000043 | 3.006.001 | Sep-23 | Apr-24 | |
| THYROID GLAND: Resection | 175.1000043 | 4.005.001 | Mar-22 | Apr-24 | |
| Hematologic | New - PRECURSOR AND MATURE LYMPHOID MALIGNANCIES | 570.1000043 | 1.000.000 | Sep-23 | Apr-24 |
| New - MYELOID AND MIXED / AMBIGUOUS LINEAGE NEOPLASMS | 571.1000043 | 1.000.000 | Sep-23 | Apr-24 | |
| New - PLASMA CELL MALIGNANCIES AND IMMUNOGLOBULIN DEPOSITION RELATED DISORDERS | 572.1000043 | 1.000.000 | Sep-23 | Apr-24 | |
| Skin | MELANOMA OF THE SKIN: Excision, Re-Excision | 259.1000043 | 2.006.001 | Jun-21 | Apr-22 |
| MELANOMA OF THE SKIN: Biopsy | 258.1000043 | 2.007.001 | Jun-21 | Apr-22 | |
| MERKEL CELL CARCINOMA OF THE SKIN: Incisional Biopsy, Excision, Re-Excision, Lymphadenectomy | 198.1000043 | 2.003.001 | Jun-21 | Apr-22 | |
| Thorax | LUNG: Resection | 119.1000043 | 3.008.011 | Jun-21 | Apr-24 |
| MALIGNANT PLEURAL MESOTHELIOMA | 160.1000043 | 3.003.011 | Jun-21 | Apr-22 | |
| THYMUS: Resection | 174.1000043 | 3.003.021 | Mar-22 | Apr-23 | |
| Biomarkers | Bone Marrow: Biomarker Reporting Template (Recommended) | 373.1000043 | 1.000.000 | Feb-19 | Apr-20 |
| BREAST: Biomarker Reporting Template | 169.1000043 | 1.008.001 | Jun-21 | Apr-22 | |
| CNS: Biomarker Reporting Template | 241.1000043 | 2.000.021 | Aug-18 | Apr-19 | |
| COLON AND RECTUM: Biomarker Reporting Template | 228.1000043 | 1.002.001 | Jun-21 | Apr-22 | |
| DNA Mismatch Repair Biomarker Testing for Checkpoint Inhibitor Immunotherapy (Recommended) | 347.1000043 | 1.000.031 | Aug-18 | Apr-19 | |
| Endometrium: Biomarker Reporting Template | 264.1000043 | 1.001.011 | Mar-22 | Apr-23 | |
| General IHC Quantitative Biomarkers (Recommended) | 515.1000043 | 1.002.001 | Sep-23 | Apr-24 | |
| LUNG: Biomarker Reporting Template | 227.1000043 | 2.001.001 | Jun-21 | Apr-22 | |
| Head and Neck Biomarkers | 522.1000043 | 1.000.001 | Sep-23 | Apr-22 | |
| Melanoma: Biomarker Reporting Template | 253.1000043 | 1.000.022 | Aug-15 | Apr-18 | |
| STOMACH: Gastric HER2 Biomarker Reporting Template | 223.1000043 | 1.003.001 | Jan-18 | Apr-19 | |
| Thyroid: Biomarker Reporting Template | 255.1000043 | 1.001.001 | Feb-20 | Apr-22 |
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*** The CUTANEOUS SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK Template is to be used for ALL RESECTABLE tumours. |
Note: OH-CCO will continue to exclude ALL biopsy pathology reports (synoptic and/or narrative format) from the pathology data quality indicators available in iPortTM.
The following electronic Cancer Checklists are excluded from monthly reporting and are optional for use:
| Body System | Excluded electronic Cancer Checklists (eCC) | CAP Template ID |
| Bone and Soft Tissue | BONE: Biopsy | 136.1000043 |
| SOFT TISSUE: Biopsy | 167.1000043 | |
| Gastrointestinal | ANUS: Excisional Biopsy or Local Excision (Transanal Disk Excision) | 133.1000043 |
| GASTROINTESTINAL STROMAL TUMOR (GIST): Biopsy | 197.1000043 | |
| Genitourinary | KIDNEY: Biopsy | 149.1000043 |
| PROSTATE GLAND: Transurethral Prostatic Resection (TUR), Enucleation Specimen (Subtotal Prostatectomy) | 190.1000043 | |
| PROSTATE NEEDLE BIOPSY - SPECIMEN LEVEL | 508.1000043 | |
| URETER, RENAL PELVIS: Biopsy | 179.1000043 | |
| URETHRA: Biopsy | 204.1000043 | |
| Gynecologic | UTERINE CERVIX: Excision (Cone/LEEP) | 183.1000043 |
| VAGINA: Biopsy | 185.1000043 | |
| Ophthalmic | RETINOBLASTOMA: Enucleation, Partial or Complete Exenteration | 163.1000043 |
| UVEAL MELANOMA: Resection (Local Resection, Enucleation, Limited or Complete Exenteration) | 184.1000043 | |
| Pediatric | EWING SARCOMA/PRIMITIVE NEUROECTODERMAL TUMOR: Biopsy | 209.1000043 |
| EWING SARCOMA/PRIMITIVE NEUROECTODERMAL TUMOR: Resection | 161.1000043 | |
| EXTRAGONADAL GERM CELL TUMOR: Biopsy | 369.1000043 | |
| EXTRAGONADAL GERM CELL TUMOR: Resection | 212.1000043 | |
| HEPATOBLASTOMA (PEDIATRIC LIVER): Biopsy | 363.1000043 | |
| HEPATOBLASTOMA (PEDIATRIC LIVER): Resection | 147.1000043 | |
| KIDNEY: Biopsy for Pediatric Renal Tumor | 366.1000043 | |
| KIDNEY: Resection for Pediatric Renal Tumor | 150.1000043 | |
| NEUROBLASTOMA: Biopsy | 364.1000043 | |
| NEUROBLASTOMA: Resection | 153.1000043 | |
| RHABDOMYOSARCOMA AND RELATED NEOPLASMS: Biopsy | 365.1000043 | |
| RHABDOMYOSARCOMA AND RELATED NEOPLASMS: Resection | 164.1000043 | |
| Other | GENERAL TUMOR: Biopsy (recommended) | 326.1000043 |
| GENERAL TUMOR: Resection (recommended) | 312.1000043 | |
| Biomarker | GIST: Biomarker Reporting Template | 242.1000043 |
| Body System | Deprecated electronic Cancer Checklists (eCC) | eCC Checklist template-id |
| Central Nervous System | BRAIN/SPINAL CORD: Biopsy/Resection | 139.1000043 |
| CNS: Histological Assessment | 351.1000043 | |
| CNS: Integrated Diagnosis | 350.1000043 | |
| Gastrointestinal | SMALL INTESTINE NEUROENDOCRINE TUMOR | 200.1000043 |
| Genitourinary | PROSTATE GLAND: Needle Biopsy | 191.1000043 |
| PROSTATE GLAND: Needle Biopsy (Note A) | 346.1000043 | |
| RENAL PELVIS: Resection/Nephroureterectomy, Partial or Complete | 162.1000043 | |
| URETER: Resection | 178.1000043 | |
| Gynecologic | FALLOPIAN TUBE: Unilateral Salpingectomy, Salpingo-oophorectomy, or Hysterectomy with Salpingo-oophorectomy | 143.1000043 |
| OVARY: Oophorectomy, Salpingo-Oophorectomy, Subtotal Oophorectomy or Removal of Tumor in Fragments, Hysterectomy with Salpingo-Oophorectomy | 155.1000043 | |
| OVARY or FALLOPIAN TUBE: Oophorectomy, Salpingectomy, Salpingo-Oophorectomy, Subtotal Oophorectomy or Removal of Tumor in Fragments, Hysterectomy With Salpingo-Oophorectomy or Salpingectomy | 257.1000043 | |
| Hematologic | BONE MARROW: Aspiration, Core (Trephine) Biopsy | 137.1000043 |
| OCULAR ADNEXA: Biopsy, Resection | 192.1000043 | |
| BONE MARROW: Final Integrated Diagnosis | 372.1000043 | |
| BONE MARROW: Histologic Assessment | 354.1000043 | |
| HODGKIN LYMPHOMA: Biopsy, Resection | 148.1000043 | |
| NON-HODGKIN LYMPHOMA/LYMPHOID NEOPLASMS: Biopsy, Resection | 154.1000043 | |
| PLASMA CELL NEOPLASM: Targeted Biopsy, Resection, or Bone Marrow Sampling | 243.1000043 | |
| OCULAR ADNEXA: Biopsy, Resection | 192.1000043 | |
| Other | PERITONEUM: Resection | 158.1000043 |
| Skin | MELANOMA OF THE SKIN: Biopsy, Excision, Re-Excision | 121.1000043 |
| SQUAMOUS CELL CARCINOMA OF THE SKIN: Biopsy, Excision, Re-excision, Lymphadenectomy | 165.1000043 | |
| Thorax | HEART: Resection | 146.1000043 |
| Biomarkers | Chronic Myelogenous Leukemia (CML): Biomarker Reporting Template | 252.1000043 |
| Chronic Lymphocytic Leukemia (CLL): Biomarker Reporting Template | 251.1000043 | |
| Diffuse Large B-Cell Lymphoma (DLBCL): Biomarker Reporting Template | 254.1000043 | |
| Myeloproliferative Neoplasms (MPN): Biomarker Reporting Template (Recommended) | 250.1000043 |
OH-CCO Monthly Synoptic DDF Reporting Inclusions
· All CAP mandated eCCs for malignant surgical resections (that are applicable to your site)
· In-situ resection reports for breast DCIS, urinary bladder, urethra and renal pelvis: ureter
· Benign/borderline resection reports for brain and spinal cord
OH-CCO Monthly Synoptic DDF Reporting Exclusions
· All other benign, borderline, in-situ or metastatic reports (ICDO-3 behavior codes 0, 1, 2 and 6 respectively), with the exception those listed under inclusions
· All biopsy, autopsy, cytology, gynecological cytology biomarker and flow cytometry reports will be electronically excluded if the hospital can send the correct report type in OBR 4
· All hematopoietic checklists (bone marrow, Hodgkin lymphoma, non-Hodgkin lymphoma)
· Consults completed on specimens from outside facilities
· *Reports where diagnosis of cancer is uncertain (sent for consult)
· *Squamous cell carcinoma cases where tumour thickness is <2cm (i.e. any squamous cell carcinoma less than pT2)
· *Re-excisions (except for re-excisions for melanoma and SCC of the skin which are required in DDF format using the appropriate eCCs)
*These are examples of the exclusions that the current CAP checklist DDF templates may not or cannot be appropriately utilized by the reporting pathologists and which CCO cannot electronically exclude from the Synoptic Pathology Reporting Indicator. These exclusions fall into the 10% window.