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The recent study by Roxburgh et al1 is the first to demonstrate that the routine use of an elastin stain to detect venous invasion (VI) in colorectal cancer specimens is a better predictor of long-term outcome than a standard H&E stain alone. It is interesting to note that the threefold increase in the detection of VI observed by these authors following the introduction of routine elastin staining was applicable to a group of general pathologists. Both in North America and the UK, the provision of colorectal cancer services is not centralised and institutions that offer exclusive reporting of colorectal cancer specimens by subspecialist gastrointestinal (GI) pathologists are in the minority. Clearly, the general, …
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