ASCP Partners for Cancer Diagnosis and Treatment InitiativeThree years of fighting cancer, one patient at a time.

www.ascp.org/globalhealth

ASCP CENTER FOR GLOBAL HEALTH

2 ASCP CENTER FOR GLOBAL HEALTH www.ascp.org/globalhealth

The American Society for Clinical Pathology (ASCP) is the largest organization of pathologists and

laboratory professionals in the world. Our current programs and activities reach more than 100

countries outside of the U.S. through the Center for Global Health (CGH) and the ASCP Board of

Certification (BOC). ASCP has been a primary laboratory partner implementing the U.S. President’s

Emergency Plan for AIDS Relief (PEPFAR), receiving more than $50 million in funding to directly

improve, strengthen, and capacitate HIV testing in laboratories around the world. In 2015, with

the success of PEPFAR, we added a new focus to our efforts—cancer in low- and middle-income

countries (LMICs). 

Our mission at ASCP is to provide excellence in education, certification, and advocacy

on behalf of the patients, pathologists and laboratory professionals across the globe. ASCP is

patient-centered in all operations, programs, and activities. ASCP is committed to improving

global health for all patients by exploring, identifying, and implementing innovative methods and

partnerships that improve laboratory practices. Our goal is not simply to engage in a series of

projects, but to create a sustainable presence in pathology and laboratory medicine around the

world, which finds solutions for each challenge encountered.

Our ability to design affordable systems, mobilize person power and apply dynamic technology in

challenging environments makes us the innovation leader in pathology and laboratory medicine.

Our board-certified pathologists’ and laboratory professionals’ willingness to offer their time and

expertise pro bono demonstrates our membership’s unwavering commitment to global health.

Our focus includes humanitarian efforts that lend expertise, physical resources, and extra hands

where needed and international certification designed to help increase the overall quality of

laboratory medicine. We make significant contributions to providing science education and creating

opportunities for continuous knowledge exchange.

ASCP works directly to address anatomic and clinical pathology service gaps. Through assessment,

gap identification, and implementation planning, ASCP executes activities and programs with

each country that meet their specific needs to fight disease now and make sustainable plans for

the future. Using this model, ASCP has expanded with partners to multiple countries in Africa and

around the world and now serves as the go to organization for impactful solutions in pathology.

For the past 40 years, HIV, tuberculosis, and malaria

have dominated the international global health agenda

as these massive killers of children and adults ravaged

the poorest parts of the world. Through a cadre of

funding programs, carefully designed interventions,

and a unified voice to combat these diseases, HIV,

tuberculosis, and malaria are on the decline. ASCP,

along with a host of other partners, was a part of this

long fight through our lab strengthening efforts with

the U.S. Centers for Disease Control and Prevention,

and PEPFAR. But with such great progress comes

new challenges. For LMICs, that seemingly new

challenge is the rising incidence of cancer.

In 2015, ASCP launched the Partners for Cancer

Diagnosis and Treatment in Africa initiative out of the

White House Office of Science and Technology Policy

in response to cancer’s massive burden in Africa and

other LMICs.

• Noncommunicable diseases (NCDs) are the leading

cause of death in Sub-Saharan Africa today.

• NCDs are increasing due to longer life expectancy.

• Cancer is a major killer in Africa, with 80%

mortality.

• Lack of access to diagnostics delays diagnosis of

curable diseases.

Across the spectrum of cancer care, all personnel

are lacking—from oncologists and surgeons to

pathologists, laboratory professionals, and ancillary

supportive services. Without diagnostics, clinicians

are unable to effectively screen for cancer, diagnose

disease, and develop care plans. Patients are lost in

the process, disease goes undetected, and clinicians

feel ineffective and frustrated. This results in the

majority of cancers not being diagnosed until they

reach an advanced stage of disease.

Recognizing the value of pathology in this continuum,

ASCP positioned itself to create sustainable solutions

that improve outcomes and save lives. And, we were

not alone. The National Cancer Institute launched

the Center for Global Health. The American Cancer

Society expanded to multiple international sites.

The Clinton Health Access Initiative, BIO Ventures

for Global Health, Health Volunteers Overseas,

International Cancer Export Corps, and a long list of

other nongovernmental organizations (NGOs) have

created, expanded, or deployed programs to combat

cancer, all in the last decade. Industry partners,

international funding agencies, and other donors are

beginning to take up the challenge. However, this is a

very long and brutal fight where we need everyone to

take part.

In 2017, the Union for International Cancer Control

(UICC) launched the C/Can 2025 City Cancer

Challenge, and the World Health Organization (WHO)

at the World Health Assembly passed a Cancer

Resolution. In 2018, WHO launched its first cancer

initiatives in cervical cancer and pediatric cancer. We

now have a WHO Essential Diagnostics List, including

tools for cancer, and a list of priority medical devices

for cancer management. The world is opening its eyes

to the behemoth of cancer in the countries of our

poorest neighbors.

Why Is Cancer Now the Challenge the World Must Face?

I am so happy that organizations around the world are now working on cancer in low- and middle-

income countries. But, this is not a new problem. As a medical student in Malawi in 2000, sitting at the

microscope in the surgical pathology laboratory at the University of Malawi College of Medicine, more

than 80% of what crossed the scope was cancer. At that time, there was no oncologist, and patients

had horrible, late-stage disease. On a trip two years later, I signed out 700 cases in four weeks,

some of which were more than six months old. I was, in a way, writing autopsy reports, not surgical

pathology diagnoses. In 2005, Partners in Health (PIH) began sending a trickle of cancer biopsies

to Brigham and Women’s Hospital for which Dana-Farber would send back chemotherapy to treat

these patients. If PIH used local pathology services at that time, it could take more than six months

to get a diagnosis. By 2010, this was a flood of cases, and the cost was beginning to catch the eye

of the Chief Financial Officer. These samples were coming from Rwanda and Haiti. Directed by Larry

Shulman, MD, from Dana-Farber, my colleague, Jim Pepoon, HT(ASCP), and I traveled to Rwanda—

we couldn’t go to Haiti because of cholera—and assessed an empty room at the newly built Butaro

District Hospital in 2012. Six months later, we had installed a fully functioning laboratory. From 2012

to 2016, two technicians using a standard protocol photographed every case and uploaded them to

iPath where they were triaged by a team of pathologists lead by myself and Jane Brock, MD, PhD.

In March of 2016, the first Partners for Cancer Diagnosis and Treatment in Africa initiative site was

launched at Butaro Hospital with whole slide imaging telepathology, an automated histology platform,

and the arrival of a newly trained Rwandan pathologist, reducing the laboratory’s turnaround time to

less than 72 hours. To date, more than 7,000 patients have been diagnosed and treated at Butaro

Hospital.

THE MESSAGE IS SIMPLE. WE CAN DIAGNOSE AND TREAT PEOPLE WITH CANCER IN AFRICA AND OTHER LMICs. THERE IS NO BARRIER THAT CAN’T BE OVERCOME TO ACHIEVE THIS, AND THE ONLY THING HOLDING US BACK IS A UNIFIED, GLOBAL PROGRAM TO DEFEAT THIS DISEASE.

Dan Milner, MD, MSc(Epi), FASCP ASCP Chief Medical Officer ”

“

ASCP CENTER FOR GLOBAL HEALTH 5

How Does ASCP Tackle Global Health Pathology Challenges? To assume that any particular solution, whether out of the box or successful in a prior location,

will always be valuable in another location is a fallacy. Every population center that does not have an

optimized cancer continuum will have a series of predictable, unique, and/or entirely unpredictable

challenges that must be identified, rationalized, and, when possible, solved. This approach underlies

the program for ASCP in global health where we begin with assessment (internal and external)

and use root cause analysis to create a list of sustainable interventions tailored to a given site. The

solutions are sometimes intuitive and require only funding to implement, while others require creative

approaches and complex logistics to accomplish.

Since the launch of Partners, we have engaged in a range of activities including the following:

• In person site assessments, expert consultations, and training

• Procurement, delivery, installation, and training for equipment

• Procurement and delivery of educational aids for trainees

• Recruitment, training, and support for pathology volunteers

• Translation of pathology tools into multiple languages

• Creation and support of global online resources

• Foreign and domestic direct conference support

• Foreign and domestic conference support for attendees (foreign and domestic)

At the heart of this program is the provision of whole-slide image-based telepathology supported

by teams of ASCP member volunteers remotely. When installed, this system allows pathologists in

our collaborating sites to have access to 15+ pathology experts via the cloud across all diseases

with a less than 24-hour turnaround time for consultations. But not every laboratory is ready for

telepathology, and some laboratories need more advanced help. The assessment process is,

therefore, crucial to designing a matching implementation plan for each site.

Measures of success in the dire situation of cancer at the moment are very easy to find, but very

difficult to collect. With a mortality rate of 80% for all cancers and, for example, an incidence

rate of 55 per 100,000 for cervical cancer, it is very easy to state that our goal should be less

than 35% mortality (typical of the U.S. and Europe) and less than four per 100,000 for cervical

cancer (U.S.). In pathology, the metric used most commonly for impact is turnaround; however,

the value of turnaround is maximized in an intact pre- and post- analytical system for cancer

care. Despite these challenges, ASCP’s impact in the last three years has been immense.

In-Person Assessments (external)

ASCP Staff and Member Volunteers—1 to 3 days per site

• Butaro, Rwanda• Kigali, Rwanda• Butare, Rwanda• Kampala, Uganda• Moshi, Tanzania• Dar es Salaam, Tanzania• Nairobi, Kenya• Addis Ababa, Ethiopia• Mbabane, eSwatini

(Swaziland)• Kinshasa, Democratic

Republic of Congo• Accra, Ghana• Kumasi, Ghana• Tamale, Ghana

• Abidjan, Cote D’Ivoire• Monrovia, Liberia• Gaborone, Botswana• Antananarivo, Madagascar• Lagos, Nigeria• Ibadan, Nigeria• Mirebalais, Haiti• Port-au-Prince, Haiti• Cali, Colombia• Asuncion, Paraguay• Kyiv, Ukraine• Ho Chi Min City, Vietnam• Hanoi, Vietnam• Yangon, Myanmar• Phnom Penh, Cambodia

Written Assessments (internal)

ASCP Collaborators and Local Teams

• Mbour, Senegal• Yaoundé, Cameroon• Gondor, Ethiopia

What Have We Done Through Our Initiative?

In-Person Trainings (external)

ASCP Staff and Member Volunteers—3 days to 4 weeks

Africa• Kigali, Rwanda – Histology Training, IHC Training,

Equipment Repair and Maintenance• Moshi, Tanzania – Histology Training, IHC Training,

Practical Grossing Training• Dar es Salaam, Tanzania – IHC Training• Addis Ababa, Ethiopia – Quality Management in AP,

Practical Grossing Training, IHC Training• Kinshasa, Democratic Republic of Congo – Histology

Laboratory Setup and Training• Monrovia, Liberia – Histology Laboratory Setup and Training• Harper, Liberia – Clinical Pathology Laboratory Training• Gaborone, Botswana – Histology and Workflow Training• Abidjan, Cote D’Ivoire – Surgical Pathology Workshop• Lagos, Nigeria – Surgical Pathology Workshop

Caribbean• Mirebalais, Haiti – Histology Laboratory Setup and Training,

Practical Grossing Training

South America• Cali, Colombia – Quality Management in Laboratories• Asuncion, Paraguay – Quality Management in Laboratories

Asia• Ho Chi Min City, Vietnam – Lymphoma/Leukemia Workshop• Yangon, Myanmar – Quality Management, Surgical Pathology

Training, Practical Grossing, Management• Phnom Penh, Cambodia - Surgical Pathology Training,

Practical Grossing, Management

Equipment Deployments

ASCP Staff With Collaborators

• Butaro, Rwanda – Automated Histology, Telepathology, Cytospin• Mirebalais, Haiti – Consumables, Telepathology• Kigali, Rwanda – Telepathology, Automated

Immunohistochemistry and Reagents• Moshi, Tanzania – Telepathology, Automated

Immunohistochemistry and Reagents, Histology Upgrades• Monrovia, Liberia – Complete Histology Laboratory Suite• Dar es Salaam, Tanzania – Telepathology,

Automated Immunohistochemistry and Reagents• Addis Ababa, Ethiopia – Automated Immunohistochemistry

and Reagents• Kampala, Uganda – Automated Immunohistochemistry and

Reagents, Histology Upgrades• Kinshasa, DRC – Histology Upgrades• Oyo, Nigeria – Microtome

Book Donation Program

ASCP Staff With Collaborative Donors

• Rwanda• Zambia• Uganda• Tanzania

• Ukraine• Nigeria• Kenya• Ethiopia

Total Books: 522

Datasets Translation

ASCP With International Collaboration on Cancer Reporting (ICCR)

• 21 datasets into French, Spanish, and Portuguese

Direct Educational Support

ASCP and Other Collaborator Online Courses

• Laboratory Management University Certificate Program Access (ASCP)

• Leadership Institute Certificate Program Access (ASCP)• Digital Pathology Certificate Program Access (NSH)

Conference and Travel Support

ASCP Staff, Member Volunteers, and Local Collaborators

• Support for LMIC Attendees to APECSA, AORTIC, CUGH, ASCP, USCAP, AKLMSO, BHGI, MeLSAT, UICC

• Support for Additional Training of LMIC Participants to Harvard, UCSF, Emory, Dartmouth, Duke

• Support for ASCP Speakers to AORTIC, CUGH, ASCP, AKLMSO, BHGI, MeLSAT, ASCO (Azerbaijan)

• Support for LMIC Conferences: AKMLSO, MeLSAT, WCLS, PIH, APECSA

ASCP CGH Global Health Travel Fellowships

ASCP Residents/Fellows to ASCP Partners Sites

2018 • Jaime Singh, MD• Dana Razzano, MD• Robyn Ndikumana, MD• Jennifer Kasten, MD, MSc,

FASCP• Priyadarshini Kumar, MD,

FASCP

2019• Victoria (Claire) Vaughan, MD• John Gross, MD, FASCP• Daniel Sullivan, MD• Erica Swenson, DO• Ezra Baraban, MD• Kelsey McHugh, MD, FASCP

Who Has Done the Work?The ASCP Center for Global Health works closely with the ASCP membership to design and execute all of our global

health activities. This has led to focal and ongoing engagement of our members around the world, including the following:

Board Certified Pathologist Virtual (Telepathology) Volunteers

Certified Laboratory Professional In-Country Training Volunteers

Pathologist (Certified and in Training) In-Country Volunteers

45 Members for 4 Countries

21 Members to 8 Countries

11 Members to 10 Countries

Through the ASCP Global

Health Travel Fellowship, I

worked alongside pathologists

and laboratorians at Makerere

University in Uganda to institute

new lab protocols, documents

and processes; digitize three

years’ worth of reports for

research and quality monitoring;

and teach residents...

IT WAS A CAREER-ALTERING OPPORTUNITY FOR ME, AND I FORMED SEVERAL SOLID PROFESSIONAL FRIENDSHIPS WHICH CONTINUE TO GROW.

Jennifer Kasten,

MD, MSc, FASCP

Through ASCP, I have traveled

to the Democratic Republic of

the Congo and JFK Hospital

in Liberia to assess and set up

histology laboratories as well

as train the staff. I have been

fortunate to present my work and

experience at the Association

of Pathologists of East, Central,

and Southern Africa and the

Medical Laboratory Scientists

Association of Tanzania.

THIS PHENOMENAL SET OF EXPERIENCES CREATED GREAT NETWORKING OPPORTUNITIES FOR MY HISTOLOGY CONSULTING ACTIVITIES.

Linda Cherepow,

HTL(ASCP)

It was a privilege to work closely

with Nigerian pathologists at

our recent surgical pathology

workshop in Lagos, Nigeria.

I LEARNED HOW THIS WELL-TRAINED GROUP WORKS WITH FEWER RESOURCES THAN IN THE U.S. AND PROVIDES HIGH LEVELS OF DIAGNOSTICS WITH THE RESOURCES AVAILABLE.

Nancy Joste,

MD, FASCP

In addition to the daily support

from ASCP members for our

clinical work in Butaro, I was able

to travel and present our work at

an international surgery meeting in

Germany where our team received

the award for best presentation for

the entire meeting.

SUPPORTING PATHOLOGISTS FROM REMOTE, UNDERSERVED AREAS TO ATTEND INTERNATIONAL MEETINGS ALLOWS US TO BE UPDATED ON CURRENT PRACTICE AND SHARE OUR CHALLENGES AND INTERESTING CASES SO OTHERS CAN LEARN FROM US.

Deogratias

Ruhangaza, MD

8 ASCP CENTER FOR GLOBAL HEALTH www.ascp.org/globalhealth

MORE THAN 95% of all patients biopsied in Rwanda have access to ASCP consultants.

Butaro (3/16-3/19)5,428 biopsies1,973 cancers406 ASCP consultations (21%)

RWANDA

MORE THAN 75% of all patients biopsied in Tanzania have access to ASCP consultants.

Moshi (12/18 – 3/19)1,230 biopsies369 cancers150 ASCP consultations (41%)

TANZANIA

Telepathology

Pathology Education Resources

ICCR Translations

Histology Improvements

Installations, Repairs, Upgrades, and Training, Including Immunohistochemistry

The pathology laboratories that ASCP has improved and for which it has increased histology services represent catchment areas of almost 50 MILLION PEOPLE.

Residency training programs in Rwanda, Uganda, Tanzania, and Nigeria have UP-TO-DATE TEXTBOOK LIBRARIES for residents and trainees.

Pathologists in practice in Rwanda, Zambia, Uganda, Tanzania, Ukraine, Nigeria, Kenya, and Ethiopia have UP-TO-DATE TEXTBOOKS for clinical sign out.

175 INDIVIDUALS have accessed ASCP online certificate education in leadership, laboratory management, and digital pathology from Ghana, Kenya, Rwanda, Uganda, Malawi, Ethiopia, Tanzania, and Nigeria.

Additional Language Access to Standardize Reporting ASCP With ICCR

The ambitious International Collaboration on Cancer Reporting program aims to create standardized reporting templates for cancers around the world.

However, in its original language (English) only one billion people would benefit.

By translating the existing datasets into French, Spanish, and Portuguese, the total is now 2.5 BILLION PEOPLE.

What Does It Really Mean?

Tumor de más de 1 cm pero no más de 2 cm ensu mayor dimensión

Version 3.0 published August 2017 ISBN: 978-1-925687-04-0 Page 3 of 3

m - Tumores primarios múltiples en un sitio único r - tumores recurrentes luego de un periodo sin enfermedady - clasificación realizada durante o luego detratamiento multimodal

T- Tumor primarioTX Tumor primario no puede ser evaluado, o tumorprobado por la existencia de células malignas enesputo o lavados bronquiales pero no visualizadoimágenes o broncoscopiaT0 Sin evidencia de tumor primarioTis Carcinoma in situa

T1 Tumor de 3 cm o menos en su mayor dimensión,rodeado por pulmón o pleura visceral, sin evidenciabroncoscópica de invasión más proximal del bronquiolobar (es decir, no en el bronquio principal) bT1mi Adenocarcinoma mínimamente invasivocT1a Tumor de 1 cm o menos en su mayor dimensión T1b

bT1c Tumor de más de 2 cm pero no más de 3 cm ensu mayor dimensiónbT2 Tumor de más de 3 cm pero no más de 5 cm;o tumor con cualquiera de las siguientes características• Involucra bronquio principal independientemente de

la distancia de la carina, pero sin involucrar la carina

• Invade pleura visceral • Asociado con atelectasis o neumonitis obstructiva que se extiende hasta la región hilar, afectando parte del pulmón o el pulmón entero

T2a Tumor de más de 3 cm pero no más de 4 cm en sumayor dimensión.T2b Tumor de más de 4 cm pero no más de 5 cm en sumayor dimensiónT3 Tumor de más de 5 cm pero no más de 7 cm en sumayor dimensión o uno que invada directamentecualquiera de las siguientes: pleura parietal, paredtorácica (incluyendo los tumores del sulcus superior),nervio frénico, pericardio parietal; o nódulo(s) tumoral(es)separado(s) en el mismo lóbulo que el tumor primario

T4 Tumor de más de 7 cm o de cualquier tamaño queinvada directamente cualquiera de las siguientes:diafragma, mediastino, corazón, grandes vasos,tráquea, nervio recurrente laríngeo, esófago, cuerpovertebral, carina; nódulo(s) tumoral(es) separado(s)en un lóbulo ipsilateral diferente que del tumor primario

ESTADIFICACIÓN PATOLÓGICA (TNM 8.a edición) (Nota 18) Nódulos linfáticos regionalesNX Nódulos linfáticos regionales no pueden ser evaluadosN0 No existen metástasis de nódulos linfáticos regionalesN1 Metástasis en nódulos linfáticos peribronquialesipsilaterales y/o en nódulos linfáticos hiliaresipsilaterales y nódulos intrapulmonares, incluyendola afectación por extensión directa N2 Metástasis en nódulo(s) linfático(s) mediastínicosipsilaterales y/o subcarinales N3 Metástasis en nódulo(s) linfático(s) mediastínicoscontralaterales, hiliares contralaterales, ipsilateraleso escalénicos contralaterales, o supraclaviculares M - Metástasis a distancia No aplicableM0 No existen metástasis a distanciaM1 Existen metastasis a distancia M1a Existencia de nódulo(s) tumoral(es) separado(s)en un lóbulo contralateral; tumor con nódulospleurales o pericárdicos o pleural maligno oderrame pericárdico

e M1b Única metástasis extratorácica en un único órganofM1c Múltiples metástasis extratorácicas en un único órgano

o en múltiples órganosa. Esto incluye adenocarcinoma in situ y carcinoma escamoso in situ.b. El infrecuente tumor de cualquier tamaño de propagación

superficial con su naturaleza invasiva limitada a la paredbronquial, el cual podría extenderse cerca al bronquio principal,también es clasificado como T1ac. Adenocarcinoma solitario (no más de 3 cm en su dimensión másgrande), con un patrón predominantemente lepídico y con unainvasión de no más de 5 mm en su mayor dimensión desdecualquier enfoque.d. Los tumores T2 con estas características se clasifican T2a si sonde 4 cm o menos o si el tamaño no se puede determinar y T2b si es mayor de 4 cm pero no más de 5 cm.e. La mayoría de los derrames pleurales (pericárdicos) con cáncerde pulmón se deben a un tumor. Sin embargo, en algunospacientes, los múltiples exámenes microscópicos del líquidopleural (pericárdico) son negativos para el tumor, y el líquidono es sanguinolento y no es un exudado. Cuando estoselementos y el juicio clínico determinan que el derrame noestá relacionado con el tumor, el derrame debe excluirsecomo un descriptor de clasificación.f. Esto incluye la participación de un solo nódulo no regional.## Reproduced with permission. Source:Brierley JD, Gospodarowicz MK

and Wittekind C (eds) (2016). UICC TNM Classification of Malignant Tumours, 8th Edition, Wiley-Blackwell.

Anticuerpos positivosAnticuerpos negativosAnticuerpos no concluyentes

Marcadores inmunohistoquímicos (Nota 16)

ESTUDIOS COMPLEMENTARIOS

Conclusiones:

Data molecular (Nota 17)Resultado del R-FCE

Mutación ausente Resultado indeterminadoMutación presente Describir

Exámen Resultado

Resultado EML4-ALK (Proteína 4 asociada al microtúbulode equinodermo - Linfoma quinasa anaplásico)

Otro, especificar

Reordenamiento ausente Resultado indeterminadoReordenamiento presenteDescribir

Estación 1involucrada

Version 3.0 published August 2017 ISBN: 978-1-925687-04-0 Page 2 of 3

ESTATUS DE NÓDULOS LINFÁTICOS (Nota 15)

Estación(es) examinada(s), especificar

No involucradonvolucrado solamente con micrometástasisInvolucrado

OTROS PROCESOS NEUROPLÁSICOS (p. ej. tumorlet, NEH, AAH, displasia)

ENFERMEDAD PULMONAR NO NEOPLÁSICA

INVASIÓN LINFOVASCULAR (Nota 11)

No aplicableMenos de 10% de tumores residuales viablesMás del 10% de tumores residuales viables Historia de tratamiento desconocida

RESPUESTA A TERAPIA NEOADYUVANTE (Nota 9)

TráqueaPared torácicaDiafragmaEsófagoCorazónGrandes vasosCuerpo vertebralNervio frénicoMediastinoGrasa mediastinalPleura mediastinalPericardio parietal Nervio laríngeo recurrente

INVASIÓN DIRECTA DE ESTRUCTURAS ADYACENTES (Nota 10) (seleccione todas las que apliquen)

INVASIÓN PLEURAL VISCERAL (Nota 12)

Extensión de la afectación pleural (Nota 13)

INVASIÓN PERINEURAL

PL1 PL2 PL3

Número de nóduloslinfáticos involucrados

Número total de nóduloslinfáticos provenientes deeste sitio

Número no puede ser determinado

Estación 2involucrada

Número no puede ser determinado

Estación 3involucrada

Número no puede ser determinado

Presente No identificada

No identificada

Indeterminada

Presente IndeterminadaNo puede evaluarse

Presente No identificada Indeterminada

No identificadaNo aplicable

ESTATUS DE MARGEN QUIRÚRGICO (Nota 14)

Margen Bronquial

Involucrado con carcinoma invasivo No involucradoNo aplicable

Involucrado solamente con carcinoma in situInvolucrado solamente con tejidoblando peribronquial

Margen vascular

Otro margen 1 (especificar p. ej. parénquima, pared torácica)

Involucrado No involucrado No aplicableInvolucrado solamente con tejido blando perivascular

Bien diferenciado Moderadamente diferenciadoPobremente diferenciado

GRADO HISTOLÓGICO (Nota 8)

IndiferenciadoNo aplicable

DISTANCIA DEL TUMOR AL MÁRGENDE RESECCIÓN MÁS CERCANO (Nota 7)

mm

Involucrado No involucrado No aplicable

Involucrado No involucrado No aplicable

Otro margen 2 (especificar p. ej. parénquima, pared torácica)

Número de nóduloslinfáticos involucrados

Número total de nóduloslinfáticos provenientes deeste sitio

Número de nóduloslinfáticos involucrados

Número total de nóduloslinfáticos provenientes deeste sitioOTROS PATRONES (si existen)

(Lista de valores proveniente de la Clasificación de Tumores de la

Organización Mundial de la Salud. Patología y Genética de Tumores

del Pulmón, Pleura, Timo y Corazón. (2015))

No es aplicable

No se puede evaluar

No identificado

Presente

ATLECTASIS/PNEUMONITIS OBSTRUCTIVA EXTENDIENDO

A LA REGIÓN HILAR

Lóbulo superior

Otros, especificar

Guía para Reporte de Histopatología de Cáncer de Pulmón

Colaboración Internacional de Reporte para Cáncer (ICCR, por sus siglas en inglés)

Version 3.0 published August 2017 IS

BN: 978-1-925687-04-0

Page 1 of 3

Apellido/Nombre

de Familia

Fecha denacimiento

Nombre(s)

Identificadores de pacientes

Fecha de la solicitudNúmero de órden/de laboratorio

PROCEDIMIENTO QUIRÚRGICO

UBICACIÓN DEL TUMOR

Elementos escritos en texto negro son PRINCIPALES. Elementos escritos en texto gris son COMPLEMENTARIOS. ALCANCE DE ESTOS DATOS

Lóbulo Medio Lóbulo inferior

Bronquio, especificar ubicación

Resección de cuña

Segmentectomía

Lobectomia

Bilobectomía

Neumonectomía

LATERALIDAD EN LA MUESTRA

Izquierda Derecha No se proporcionó

NÓDULOS TUMORALES SEPARADOS (Nota 1)

Ausentes No puede evaluarse

Primarias sincrónicas (Elementos PRINCIPALES

deben ser reportados para cada primaria sincrónica)

Presente

Número de tumores

Ubicación

Mismo lóbulo

Lóbulo ipsilateral diferente

Pulmón contralateral

ASPECTO MACROSCÓPICO DE LA PLEURA

TUMOR SUPERPUESTO

(Nota 2)

(Nota 3)

Carcinoma de células escamosas

Queratinizantes

No queratinizantes

Basaloide

Carcinoma neuroendocrino de células grandes

Carcinoma de células grandes

Carcinoma de células pequeñas

Adenocarcinoma

TIPO HISTOLÓGICO DE TUMOR (Nota 6)

(seleccione todos los que apliquen)

Presente Ausente No puede evaluarseusente

TUMOR INVOLUCRA BRONQUIO PRINCIPAL

ESTRUCTURAS ANATÓMICAS CONECTADAS

Presentadas Ninguna presentada

MUESTRAS ACOMPAÑANTES

Ninguna presentada Otros, especificar

Clasificación de Adenocarcinoma

Adenocarcinoma in situ (AIS)

No mucinoso Mucinoso

Adenocarcinoma mínimamente invasivo (MIA)

No mucinoso Mucinoso

Escamoso

Acinar

Papilar

Micropapilar

Sólido

Mucinoso Invasivo

Coloide

Fetal

Entérico

No es aplicable

No se puede evaluar

No identificado

Presente

MÁXIMA DIMENSIÓN TUMORAL (Nota 4)

mm

TUMOR IMPLICA CARINA (Nota 5)

%

TIPO DE PATRÓN

%

TIPO DE PATRÓN

%

TIPO DE PATRÓN

Adenocarcinoma Invasivo

PATRÓN PREDOMINANTE

CarcinoideTípicoAtípico

%

Otro, especificar

DD – MM – YYYY

DD – MM – YYYY

Ganglios linfáticos

10 ASCP CENTER FOR GLOBAL HEALTH www.ascp.org/globalhealth

Where Are We Going Next?

For 2019 to 2021, ASCP needs multi-funder support for the following priority areas:

Expansion of our existing core program of diagnostic support to an additional 10+ countries

• Histology, telepathology, immunohistochemistry• Increase in potential access from the current 50 million people up to 400 million people• Increase in secondary consultations from 50 pathologists to 450 pathologists• Increase in our member engagement from 77 members to 250 members

Expansion of in-person expert consultations through our own initiatives and collaborative programs in parallel with implementation planning and execution of pathology creation or improvement

• Increased impact from our current 50 million people to 400 million people

Creation of a “Laboratory Boot Camp” program pairing laboratory professionals with selected field sites to provide one-week, intensive training in specific topics developed with the needs of the field sites as a priority

• Medical laboratory scientists/technologists, pathologists’ assistants, histotechnologists, and cytotechnologists

• Projected impact is 1,000 to 1,500 trained individuals in LMICs per year• Projected member engagement is 40 to 80 members per year

Expansion and ongoing support of our translation program from Spanish, French, and Portuguese for the existing 21 datasets

• Current impact is 2.5 billion people (English, French, Spanish, Portuguese)• Increased impact to 4.5 billion people (Russian, Chinese, and German)• ICCR to release 54 additional datasets (about 10 to 20 per year) from 2019 – 2024

Development, with several partners, of a self-sustaining, external quality assurance program for cancer diagnostics in Africa through shared resources and cross-subsidy funding

• Project impact in first phase 113 million people

Our overarching goal at ASCP in

global health is 100% access to

diagnostics and treatment for all

patients everywhere.

Our cancer focus is broad, as a

histology slide can diagnose any

cancer from all body sites. Our

technical interventions have/can

include(d) histology, immunohisto-

chemistry, flow cytometry, clinical

laboratory medicine, molecular diag-

nostics, and targeted therapies.

If you have any interest in more

details about our plans, project

impact, specific fiscal needs, or other

programs, please reach out to ASCP

directly (dan.milner@ascp.org).

We would love to have your financial

support for our ongoing efforts and

ideally need multiple, committed

funders for three years to reach our

goal budget of $5 million+ dollars for

2019-2021.

ASCP Center for Global Health33 West Monroe Street, Suite 1600Chicago, IL 60603

312.541.4999

www.ascp.org/globalhealth

globalhealth@ascp.org

Total ASCP CGH Funding for Global Health Activities (2016 – 2019)

ASCP CGH Global Health Project Activities (excluding PEPFAR) $4,232,000*

ASCP CGH PEPFAR Activities $7,053,892

*Exclusive of ASCP member volunteer hours contributed