SEER Inquiry System - Question 20100110 Details

SINQ 20000245 states that high grade or severe dysplasia in not synonymous with in situ disease. However, per page 109 in the 7th edition of AJCC Cancer Staging Manual, high grade dysplasia is the only term listed under Tis. A note on that page explains that "high-grade dysplasia includes all noninvasive neoplastic epithelia that was formerly called carcinoma in situ, a diagnosis that is no longer used for columnar mucosae anywhere in the gastrointestinal tract."

There has been considerable pressure from registrars at larger reporting facilities to re-address this issue. The pathologists at these facilities state that they are correctly documenting the presence of in situ disease when they use the term high grade dysplasia for gastrointestinal tract tumors. In their opinion, it is not necessary to add the term in situ in parentheses following the use of the term high grade dysplasia to clarify the behavior of these lesions in their pathology reports. If the term "carcinoma in situ" is no longer being used by many pathologists for sites in the gastrointestinal tract, won't this lead to underreporting of in situ disease for these sites unless the reportability guidelines are changed?