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The Colorectal Cancer Pathology Report 101


After a biopsy, a doctor known as a pathologist will examine a tissue sample and prepare a report of the results. The report is known as a pathology report.

The pathology report will be sent to the doctor who did the biopsy. That doctor will review the pathology report with you.

The pathology report should be able to tell you whether you have colorectal cancer or not. If you do, the report will include information about the type of colorectal cancer, grade and staging. It will also state if there is any uncertainty about the findings. The information in the report is used to determine the best treatment for you.

In general, the pathology report includes:

  • The type of colorectal cancer.
    • 90-95% of colorectal cancer is adenocarcinoma which is cancer of the glands in the colon. The remaining types include melanoma, lymphoma, carcinoid and neuroendocrine tumors.
    • There are three subtypes of adenocarcinoma. Regular adenocarcinomas are the most common type. The others are mucinous which accounts for 10-15% of adenocarcinoma cases and signet cell which accounts for 0.1%. The distinctions are based on the appearance of the cells under a microscope.
  • The grade of the cancer cells. Grade is classified by how closely the cancer cells resemble their normal healthy counterparts, or how much dysplasia cellular changes there are. The grading criteria is as follows:
    • Low Grade: well differentiated (G1) or moderately differentiated (G2). 
    • High Grade: poorly differentiated (G3) or undifferentiated (G4) High grade is not as good as low grade.
  • Staging. A colorectal cancer's stage indicates how far it has spread within the colorectuml, to nearby tissues and other organs. The stages of colorectal cancer are classified as 0, I, II, III and IV. The stages are further broken down with T, N and M ratings. Information about staging, including the meaning of each stage, is in the documents Staging: Colon Cancer and Staging: Rectal Cancer. 

The additional information contained in a pathology report is described in the document: How To Understand A Pathology Report. If you have difficulty understanding any of the terms in the report, look at the National Cancer Institute's Dictionary of Cancer Terms by clicking here offsite link.

Every patient should obtain a copy of the pathology report so that:

  • You can discuss it in a meaningful way with your doctor.
  • You will have a copy on hand so there will be no delay if other doctors want to see the report.

You are entitled to receive a copy of the pathology report.

  • The report is supposed to be written so that lay people with no medical knowledge can understand it. If there are questions, ask your doctor.
  • You may need to sign a consent form in order to obtain a copy of the pathology report.
  • A fee may be charged for the copy.

If there are any questions about the pathologist's opinion, consider getting a second pathology opinion. For example, from a pathologist at a major academic cancer center or a National Cancer Institute certified comprehensive cancer center. You can locate such a center by clicking here offsite link.

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