Histopathology Diagnostics in the Philippine Primary Care Setting: Gaps, Challenges, and Opportunities

Objectives: The practice of histopathology, also known as surgical pathology, in the Philippines reliesmainly on routine paraffin processing and hematoxylin and eosin (H&E) staining. Although useful inresource-limited settings, overreliance on H&E methods may preclude a more targeted approach topatient management. This paper provides an overview of the current practices in the country and aims to identify their gaps and challenges.Methods: The authors provide an overview of the current practices in the Philippines and identify thegaps by comparing the practices in select tertiary institutions. They also reviewed the literature todetermine how advances in community pathology, digital pathology, and molecular pathology may beable to address the current challenges that pathologists in community hospitals encounter.Discussion: Community pathology provides the framework by which hospitals in suburban and ruralsettings may be able to deliver histopathology services. Digital pathology, through telepathology, bridgesgeneral pathologists to specialist pathologists without having to transport slides and specimens. Finally,although some methods might be expensive, molecular pathology allows the identification anddevelopment of assays that may be applicable in community hospitals.Conclusion: There is a need to ensure that community hospitals are able to provide quality and accessiblehistopathology services that maximize available resources. Advances in the other fields of pathology maycontribute towards the establishment of referral networks that ultimately benefit patients in the primarycare setting.