1.500.000 Synoptic pathology reports marks another milestone for PALGA

As one of the first countries in the world, the Netherlands introduced synoptic (i.e. uniform) pathology reporting in 2008. Currently synoptic reporting protocols are nationally available for 23 disease areas, such as breast cancer and colorectal cancer, resulting in 31 national histology and cytology protocols for fine needle aspirations, biopsies and resection.


All pathology reports, irrespective of synoptic reports, in the Netherlands are stored locally in the pathology labs, and in the nationwide pathology archives PALGA. During the summer of 2019, PALGA filed the one and a half millionth synoptic report, thereby marking another milestone of being a frontrunner in this area worldwide.

A brief history

The introduction of synoptic reporting is driven by the importance of detailed and accurate information in pathology reports. In the Netherlands PALGA started with the development of synoptic reporting protocols for colorectal and breast cancer late 2008, based on multidisciplinary guidelines, WHO Classifications and since 2011 based on the minimal datasets of the International Collaboration on Cancer Reporting (ICCR). PALGA Foundation develops, distributes nationwide and maintains all the national Pathology Protocols for Histology, Cytology and Molecular Testing. Direct distribution and daily maintenance is possible due to the connection of all Dutch laboratories within the PALGA network. 

A protocol for standardization in clinical practice

In 2012, PALGA performed an overhaul of the software systems and developed a complete new framework for the use of synoptic reporting in daily practice. This was necessary because due to the implementation of more protocols, already between 20-25% daily workload of the Dutch pathologist is related to synoptic reporting and so the protocols should be incorporated within the normal workflow. The new framework enables PALGA to combine different protocols in one pathology report, including standardized reported molecular outcome data, derived from next generation sequencing.


Multiple use

The data from the standardized reports are made available to a number of registries, ensuring high quality accurate pathology data. Direct data transfer connections are present with the National Cancer Registry, the Dutch Institute for Clinical Auditing and the population screening programs for colorectal, cervical cancer and breast cancer  from the National Institute for Public Health and the Environment . Through interoperability the pathology data are directly imported in these registries without intervention of data managers, this saves time and registration burden.  This way in 2018 more than three hundred thousand standardized reports were sent to these registries.


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To learn more about PALGA, please contact:

Paul Seegers (Advisor & Administrator, national pathology protocols) paul.seegers@palga.nl

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