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The Third Reader

If the pathology report is our work, then making sure the patient can understand what we have said is part of our work as well

By Kamran Mirza 09/08/2026 Opinion 10 min read

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Clinical Report: The Third Reader

Overview

A study highlights significant disparities in patient understanding of prostate biopsy reports, with 39% correctly identifying cancer in standard reports compared to 93% in patient-centered versions.

Background

The accessibility of pathology reports to patients has increased dramatically since the implementation of the 21st Century Cures Act in April 2021. This change has led to patients encountering complex medical terminology without adequate support.

Data Highlights

Report TypeCorrect Cancer Identification
Standard Report39%
Patient-Centered Report93%

Key Findings

  • 39% of patients understood cancer presence in standard biopsy reports.
  • 93% of patients understood cancer presence in patient-centered reports.
  • 7% of patients learned their diagnosis through electronic portals.
  • 71% of patients who learned their diagnosis online were at home and alone.
  • 56% of AI users lack confidence in chatbot health information accuracy.

Clinical Implications

Healthcare providers should consider the implications of direct patient access to pathology reports.

Conclusion

The evolving landscape of patient access to medical information necessitates a reevaluation of how pathology reports are communicated.

Related Resources & Content

  1. JAMA, 2025 -- Study on Patient-Centered Pathology Reports
  2. NCCN Guidelines® Insights: Prostate Cancer, Version 5.2026
  3. Current Cancer Protocols - CAP
  4. Eyecare Business — The Reader Rage
  5. Eyecare Business — ACCESSORIES CLOSE UP: READERS
  6. Eyecare Business — Reader Go-Round
  7. Optometric Management — reflections: Third-World Reminders
  8. The Reader Rage
  9. ACCESSORIES CLOSE UP: READERS
  10. Reader Go-Round
  11. Information Blocking - ONC - Office of the National Coordinator for Health Information Technology
  12. NCCN Guidelines® Insights: Prostate Cancer, Version 5.2026 - PubMed
  13. Current Cancer Protocols - CAP

References

  1. CJ Lapedis et al., "Knowledge and worry following review of standard vs patient-centered pathology reports," JAMA, 333, 8 (2025). PMID: 39745765.
  2. S Bhalla et al., "Contemporary trends in reviewing test results through the electronic patient portal among patients with cancer," JAMA Oncol, 10, 1 (2024). PMID: 38032648.
  3. K Ruder, "Running your lab results by ChatGPT? Here is what to keep in mind," NPR Shots (2025). Available at https://www.npr.org/sections/shots-health-news/2025/09/11/nx-s1-5537067/ai-medicine-privacy-test-results
  4. M Presiado et al., "Health misinformation tracking poll: artificial intelligence and health information," KFF (20240 Available at https://www.kff.org/public-opinion/kff-health-misinformation-tracking-poll-artificial-intelligence-and-health-information/
  5. P Prucker et al., "A prospective controlled trial of large language model-based simplification of oncologic CT reports for patients with cancer," Radiology, 317, 2 (2025). PMID: 41251553.
  6. J Naidu et al., "Large language models in radiologist-patient communication: a narrative review for clinical practice," Cureus, 18, 1 (2026). PMID: 41728578.
  7. H Armitage, "AI tool assists doctors in sharing lab results," Stanford Medicine News (2025). Available at https://med.stanford.edu/news/all-news/2025/01/ai-test-results.html
  8. Quest Diagnostics, "Quest Diagnostics introduces AI Companion to help patients understand and act on lab test results," press release, March 2, 2026. Available at https://ir.questdiagnostics.com/press-releases/press-release-details/2026/Quest-Diagnostics-Introduces-AI-Companion-to-Help-Patients-Understand-and-Act-on-Lab-Test-Results/default.aspx
  9. College of American Pathologists, "Cancer protocol templates: cancer reporting and biomarker reporting protocols," Q2 2026 release, 17 June 2026. Available at https://www.cap.org/protocols-and-guidelines/cancer-protocols/current-cancer-protocols/
  10. AL Booth et al., "Please help me see the dragon I am slaying: implementation of a novel patient-pathologist consultation program and survey of patient experience," Arch Pathol Lab Med, 143, 7 (2019). PMID:30398913.
  11. E Shachar et al., "Pathology consultation clinic for patients with cancer: meeting the clinician behind the microscope," JCO Oncol Pract, 17, 10 (2021). PMID: 33797957.
  12. C Lapedis et al., "The patient-pathologist consultation program: a mixed-methods study of interest and motivations in cancer patients," Arch Pathol Lab Med, 144, 4 (2020). PMID: 31429605.
  13. SE Bergholtz et al., "A mixed-methods study of clinicians' attitudes toward pathology explanation clinics," Am J Clin Pathol, 159, 5 (2023). PMID: 36821476.
  14. H Bristow, "Pathology clinics: bringing the lab out of the basement," The Pathologist (2026). Available at https://thepathologist.com/issues/2026/articles/january/pathology-clinics-bringing-the-lab-out-of-the-basement/
  15. American Society for Clinical Pathology, "ASCP deepens commitment to pathologist workforce development," press release, September 11, 2025. Available at https://www.ascp.org/news/news-details/2025/09/11/ascp-deepens-commitment-to-pathologist-workforce-development?srsltid=AfmBOoptJ48DIsub9BeZ_WDQqjGCktfoUiId4rfXJcXdZ7TpwYKOm587
  16. Artera, "Artera receives US FDA De Novo marketing authorization for AI-digital pathology software," press release, August 13, 2025. Available at https://artera.ai/news/artera-receives-u-s-fda-de-novo-marketing-authorization-for-ai-digital-pathology-software-revolutionizing-prostate-cancer-care

About the Author(s)

Kamran Mirza

Kamran M. Mirza, MD, PhD, FCAP, FASCP, Godfrey D. Stobbe Professor of Pathology Education, University of Michigan Medical School; Assistant Chair for Education, Department of Pathology, Michigan Medicine.

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