• Surgical pathology
• colon
• surgery
• colorectal cancer
• diabetes
• pancreatic b-cell function
• pancreas
• gastrointestinal disease
• gall bladder
• oncogenes
• p53
• cancer
• metastasis

We read with interest the article by Messenger et al1 describing current practice patterns for the assessment of venous invasion in colorectal cancer in Ontario, Canada. The authors highlight the low reporting rates of venous invasion across the region with 70% of pathologists identifying venous invasion in fewer than 10% of cases. Such rates are some way below the Royal College of Pathologists' minimum audit threshold of 25%. The authors report that pathologists who employed elastin stains in their practice had a higher rate of detection of venous invasion; however, there was little enthusiasm for the widespread application of such a technique.

In our institution, a departmental audit of 75 colorectal cancer resections between 1997 and 2000 demonstrated a prevalence of venous invasion of 18%.2 When all …