Doctors who study cancer samples need clear instructions on what tests to run and how to report the results. The College of American Pathologists, a major medical organization, just updated their guidelines for testing women’s gynecologic cancers (cancers of the reproductive system). These updated instructions include new types of tests that can help predict how a cancer might behave and which treatments might work best. The guidelines now cover important markers like PD-L1 and folate receptor alpha, which are becoming increasingly important for choosing the right treatment. These clearer instructions help ensure that all patients get consistent, high-quality testing and reporting.

The Quick Take

  • What they studied: How pathologists (doctors who examine tissue samples) should test and report results for women’s gynecologic cancers, including what new tests should be included and how to explain the results clearly.
  • Who participated: Expert pathologists and cancer specialists from the College of American Pathologists worked together to review current medical evidence and create updated testing guidelines.
  • Key finding: The updated guidelines now include several new biomarkers (biological signs) that help doctors understand cancer better and choose better treatments, including tests for PD-L1, folate receptor alpha, and certain patterns of p53 protein expression.
  • What it means for you: If you or someone you know is diagnosed with a gynecologic cancer, the tissue sample will likely be tested using these updated guidelines, which may help doctors choose more personalized and effective treatment options. However, these are guidelines for doctors and lab professionals, not direct patient treatments.

The Research Details

This is a clinical guideline document, not a traditional research study. The College of American Pathologists assembled a team of experts who specialize in studying gynecologic cancers. These experts reviewed all the latest scientific research, looked at what major cancer organizations recommend, and evaluated what tests are most helpful in real-world medical practice. They then created clear, standardized instructions for how pathologists should perform these tests and report the results to doctors treating cancer patients. The guidelines were first released in 2022, with small updates in 2023, and now a major update in December 2024 based on new discoveries in cancer testing.

When different labs test cancer samples differently or report results in different ways, it can confuse doctors and lead to inconsistent treatment decisions. By creating standardized guidelines, the College of American Pathologists helps ensure that every patient gets the same quality of testing and clear, understandable results. This is especially important because new types of cancer tests are being developed constantly, and doctors need clear guidance on which ones to use and how to interpret them.

These guidelines are created by leading experts in the field and are based on current scientific evidence and established medical practice standards. The guidelines are regularly updated as new research emerges. However, this is a guideline document rather than a research study testing a specific treatment, so it doesn’t have traditional measures of study quality like sample size or statistical analysis.

What the Results Show

The updated guidelines now include testing for several important biomarkers that help doctors understand gynecologic cancers better. These include PD-L1 (a protein that affects how the immune system fights cancer), folate receptor alpha (which helps determine if certain targeted drugs might work), and specific patterns of p53 protein expression (which indicates how aggressive the cancer might be). The guidelines also clarify how to test for HER2 (a protein that affects cancer growth) and mismatch repair proteins (which relate to how well the cancer’s DNA copying system works). Each biomarker has detailed explanations of why it matters, how to test for it correctly, and what the results mean for treatment decisions.

The updated guidelines include improved explanations of hormone receptors (proteins that respond to estrogen and progesterone), which are important for many gynecologic cancers. The guidelines also address how to handle situations where only some cancer cells show certain biomarkers (called ‘subclonal’ patterns), which can affect treatment choices. Additionally, the guidelines provide examples and illustrations to help pathologists avoid common testing mistakes and ensure consistent reporting across different laboratories.

The original 2022 version of these guidelines covered basic biomarkers like hormone receptors and HER2. The 2023 update made small clarifications. This 2024 update represents a significant expansion, adding newer biomarkers like PD-L1 and folate receptor alpha that have become important as cancer treatment options have evolved. The new guidelines reflect how cancer testing has become more sophisticated and personalized, with more options available to help doctors choose the best treatment for each patient’s specific cancer.

These are professional guidelines rather than research testing a specific treatment, so they don’t have traditional study limitations. However, the guidelines depend on the quality of available scientific evidence, which continues to evolve. Some of the newer biomarkers (like PD-L1 and folate receptor alpha) may have less extensive research than older markers. The guidelines are designed for pathologists and laboratory professionals, not for patients to interpret on their own. Additionally, having a biomarker doesn’t guarantee that a particular treatment will work—it’s one piece of information doctors use to make treatment decisions.

The Bottom Line

If you have been diagnosed with a gynecologic cancer, ask your doctor whether your tissue sample has been tested using these updated guidelines and what the results mean for your treatment options. These guidelines help ensure you receive consistent, high-quality testing. However, the specific treatment recommendations should come from your oncologist (cancer doctor) based on your individual situation. Confidence level: High—these guidelines are based on current medical evidence and expert consensus.

Women diagnosed with gynecologic cancers (ovarian, endometrial, cervical, and related cancers) should care about these guidelines because they affect the quality of testing and information their doctors receive. Pathologists and laboratory professionals should follow these guidelines to ensure consistent, accurate testing. Family members and caregivers of women with gynecologic cancer may find this information helpful for understanding the testing process. These guidelines are not directly relevant to people without a gynecologic cancer diagnosis.

The testing itself typically happens within days to weeks after a tissue sample is taken. The results help doctors decide on treatment, which may begin within weeks of diagnosis. The benefits of proper testing appear immediately in the form of better-informed treatment decisions, though the actual health benefits depend on how well the chosen treatment works for that individual patient.

Want to Apply This Research?

  • If you have a gynecologic cancer diagnosis, track which biomarkers were tested in your tissue sample and what the results were. Create a simple list: test name, result, and date performed. This helps you and your doctor keep organized records and ensures nothing is missed.
  • Request a copy of your pathology report and ask your doctor to explain which biomarkers were tested and what each result means for your treatment options. Keep this information in a health folder or app so you have it for all your medical appointments.
  • Maintain a record of all biomarker testing done on your cancer samples throughout your treatment. If you receive additional biopsies or samples are tested again, add the new results to your records. Share this information with all your doctors to ensure coordinated, consistent care.

This article explains professional guidelines for pathologists and laboratory professionals who test cancer samples. It is not medical advice and should not be used to make treatment decisions. If you have been diagnosed with a gynecologic cancer or have questions about biomarker testing, please discuss these guidelines and your specific test results with your oncologist or healthcare provider. The information in these guidelines is based on current medical evidence, but medical knowledge continues to evolve. Your doctor is the best source for understanding what your individual test results mean and how they apply to your specific situation.