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Current Status of Pathologic Examinations in Korea, 2011–2015, Based on the Health Insurance Review and Assessment Service Dataset
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Original Article
Current Status of Pathologic Examinations in Korea, 2011–2015, Based on the Health Insurance Review and Assessment Service Dataset
Sun-ju Byeon
Journal of Pathology and Translational Medicine 2017;51(2):137-147.
DOI: https://doi.org/10.4132/jptm.2016.12.30
Published online: February 22, 2017

Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Corresponding Author Sun-ju Byeon, MD Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-1494 Fax: +82-2-472-7898 E-mail: byeon.sunju@welovedoctor.com
• Received: July 13, 2016   • Revised: November 28, 2016   • Accepted: December 30, 2016

© 2017 The Korean Society of Pathologists/The Korean Society for Cytopathology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Background
    Pathologic examinations play an important role in medical services. Until recently, the overall status of pathologic examinations in Korea has not been identified. I conducted a nationwide survey of pathologic examination status using the insurance reimbursements (IRs) dataset from the Health Insurance Review and Assessment Service (HIRA). The aims of this study were to estimate current pathologic examination status in Korea and to provide information for future resource arrangement in the pathology area.
  • Methods
    I asked HIRA to provide data on IR requests, including pathologic examinations from 2011 to 2015. Pathologic examination status was investigated according to the following categories: annual statistics, requesting department, type of medical institution, administrative district, and location at which pathologic examinations were performed.
  • Results
    Histologic mapping, immunohistochemistry, and cervicovaginal examinations have increased in the last 5 years. Internal medicine, general surgery, obstetrics/gynecology, and urology were the most common medical departments requesting pathologic examinations. The majority of pathologic examinations were frequently performed in tertiary hospitals. About 60.3% of pathologic examinations were requested in medical institutions located in Seoul, Gyeonggi-do, and Busan. More than half of the biopsies and aspiration cytologic examinations were performed using outside services. The mean period between IR requests and 99 percentile IR request completion inspections was 6.2 months.
  • Conclusions
    This survey was based on the HIRA dataset, which is one of the largest medical datasets in Korea. The trends of some pathologic examinations were reflected in the policies and needs for detailed diagnosis. The numbers and proportions of pathologic examinations were correlated with the population and medical institutions of the area, as well as patient preference. These data will be helpful for future resource arrangement in the pathology area.
Pathologic examinations play an important role in medical services. Until recently, overall pathologic examination status in Korea has not been investigated. Understanding the current pathologic examination status is important to establishing future plans for resource arrangement. Byeon and Kim [1] reported the estimated pathologic examination status in Korea using the Health Insurance Review and Assessment Service (HIRA)–National Patient Sample (NPS). Because the HIRA-NPS data was statistically extracted (selection probability, 0.03), some amount of statistical error is inevitable [2]. The current study is a follow-up study using the raw dataset from HIRA. The HIRA dataset did not contain any rejected inspections of insurance reimbursement (IR) requests or new diagnostic techniques that were not approved by various government organizations. However, this dataset is one of the largest medical datasets and it best reflects the current pathologic examination status in Korea. The aims of this study are to estimate the current pathologic examination status according to multiple parameters in Korea, to provide information for future resource arrangement in the pathology era, and to compare differences between NPS and the raw data.
I requested HIRA to provide the IRs for various pathologic examinations (Table 1) from 2011 to 2015 (data extraction was performed in May 2016). The HIRA provided the data after anonymizing the patient identification numbers and hospital identification numbers. Primary data processing was performed using the R Statistical Software (Foundation for Statistical Computing, Vienna, Austria) ver. 3.2.3 in a remote access system for HIRA. Secondary data processing was performed using the R Statistical Software ver. 3.3.1 using the t2.micro instance in the Amazon Elastic Compute Cloud (Amazon, Seattle, WA, USA). To evaluate the tendency of each pathologic examination number from 2011 to 2015, linear regression was applied. A p-value less than .05 was regarded as statistically significant.
I estimated the mean period between IR requests and completion of the IR inspections as follows. Since HIRA did not provide the exact date of completion for the IR inspections and provided their data on a monthly basisinstead, a table containing monthly pathologic examination status from January 2011 to December 2014 was formulated, as seen in Table 1 (pathologic examinations in 2015 were excluded due to incomplete IR request inspections). Using this table as the reference table, I obtained sequentially cumulative data by adding up the monthly number, thereby marking the period pertaining to the 33, 66, and 99 percentile inspections of IR requests. Next, I made up the same table again as sequentially. I obtained the time more than 33, 66 and 99 percentile inspections of IR requests were done.
The abbreviations used in this study are as follows. AC, aspiration cytopathology; BFC, body fluid cytopathology; BONE, histopathologic examination for bone; CB, cell block; CERVIX, cervicovaginal cytopathology; EM, tissue electron microscopy; ENZYME, enzyme histochemistry; FS, emergency histopathologic examination during surgery; HER2 (FISH), HER2 gene fluorescence in situ hybridization; HER2 (SISH), HER2 gene silver in situ hybridization; HR, examination of hormone receptor in tissue; IF, tissue immunofluorescent microscopic examination; IHC, immunohisto(cyto)chemistry; L-, liquid based; LND, with lymph node dissection; LNDX, without lymph node dissection; MaligGro, resected specimen for malignant tumor requiring gross sectioning; MAPPING, histologic mapping of tumor; MSI, microsatellite instability; Non-maligGro, resected specimen requiring gross sectioning; NPB, number of paraffin blocks; OUTSIDE, outside slide interpretation; SPECIAL, special stain examinations.
A summary and the details for annual pathologic examination status are given in Table 2 and Supplementary Table S1, respectively. Among the main categories, it was found that the total numbers of MAPPING, IF, EM, IHC, CERVIX, and BFC increased during 2011–2015, while the total numbers of ENZYME and CB were decreased. In more detail, the following pathologic examinations increased in 2011–2015: non-maligGro with NPB ≤6, MAPPING LND, MAPPING LNDX, Masson’s trichrome stain, IF (IgG, IgA, IgM, C3, C4, fibrinogen, others), EM, IHC (interpretation by qualified doctor, HR, EGFR pharmDx kit), L-CERVIX, L-BFC, L-AC, CB after L-AC, and some of OUTSIDE (C5500009, C5912009, C5916009, C5917009). The following pathologic examinations decreased in 2011-2015: biopsy (more than 13 pieces), IF (IgE and hepatitis B surface antigen), ENZYME (acetylcholinesterase), CERVIX by smear, BFC (general), AC (conventional), and CB (AC). Note that no chloroacetate esterase examinations were performed during the last 5 years.
Most medical and dental departments requested various pathologic examinations (a summary is given in Tables 3 and 4 and the details are given in Supplementary Table S2), but the proportions were quite different. Internal medicine (13,917,799, 46.29%), general surgery (6,334,913, 21.07%), obstetrics/gynecology (3,444,796, 11.46%), and urology (1,769,651, 5.89%) were the most common medical departments (25,467,159, 84.70%) requesting pathologic examinations. These proportions were similar to those of the previous study [1].
A summary and the details of the pathologic examination status according to type of medical institution are listed in Table 5 and Supplementary Table S3, respectively. The numbers of each type of medical institution were not included in this analysis. The majority of pathologic examinations were frequently performed in a tertiary hospital. Among the different pathologic examinations, biopsy and AC were frequently performed in clinics.
A summary and the details of the pathologic examination status according to the administrative district are listed in Tables 6, 7, and Supplementary Table S4, respectively. About 60.3% of pathologic examinations (20,787,770) were requested in medical institutions located in Seoul (12,249,590, 35.5%), Gyeonggi-do (5,517,990, 16.0%), and Busan (3,020,190, 8.8%).
A summary and the details of the pathologic examination status according to the location at which examinations were performed are listed in Table 8 and Supplementary Table S5, respectively. More than 90% of the resected specimens for malignant tumors requiring gross sectioning (MaligGro) LND, MaligGro LNDX, MAPPING, emergency histopathologic examination during surgery (FS), ENZYME, IHC, CB, and OUTSIDE were performed in their own hospitals. More than half of the biopsies and AC examinations were performed using outside services.
The mean periods between IR requests and the 33, 66, and 99 percentiles IR request inspection completions were 2.2, 2.8, and 6.2 months, respectively. The kernel density estimation plot for each percentile can be found in Fig. 1. The 95 and 99 percentile values of the period for 99 percentile IR request inspection completion were 11 and 25 months, respectively.
In this study, I investigated various pathologic examination status according to the following categories: annual statistics, requesting department, type of medical institution, administrative district, and location at which pathologic examinations were performed in Korea, 2011–2015. In the last 5 years, the total numbers of MAPPING and IHC increased. These trends reflect the need for a more accurate pathologic diagnosis. Contrary to how the number of conventional cytopathologic examinations decreased, the number of variable liquid-based cytopathologic examinations increased. After FISH and SISH based HER2 gene examinations were approved by insurance companies in 2013, the number of HER2 gene examinations increased. These trends reflect both insurance and public health policies.
Throughout many medical institutions in Korea, pathologists will order a large amount of pathologic examinations for diagnosis. However, only 0.04% of pathologic examinations have been claimed by pathologic departments. These discrepancies come from the difference between actual and administrative claims. In tertiary and general hospitals, various medical examinations were requested based on the inpatient department. In clinics, medical examinations were usually requested based on the major disease code of the patient.
According to HIRA (http://opendata.hira.or.kr/op/opc/olapMdclRcStatsInfo.do) and the Ministry of the Interior (http://rcps.egov.go.kr:8081/jsp/stat/ppl_stat_jf.jsp), there were 53,252 medical institutions and 51,677,054 people in Korea in December, 2015 (see Supplementary Table S6). The total number of pathologic examinations in each administrative district was positively correlated with both the number of medical institutions and people in the area (both p<.001). About 61.7% of OUTSIDE were performed in medical institutions located in Seoul. The proportion of OUTSIDE was higher than the population ratio of Seoul (10,022,181, 19.4%). This phenomenon reflects the patient preference for major medical institutions in Seoul.
Compared to previous studies using common pathologic examination codes in 2013 (approximately 5,440,288 pathologic examinations using the NPS data), there was a 3.2% increase in pathologic examinations (5,615,395 pathologic examinations in 2013). This difference was found to be in the acceptable range as determined by the pilot study. When using the raw HIRA data, implementation of basic algorithms using the NPS data is recommended.
In conclusion, even though this survey using the HIRA dataset did not reflect the exact current status, it is still quite accurate. I expect the present study to help with future operations for the Korean Society of Pathology in terms of understanding the current status and trends of pathologic examinations. I recommended that an in-depth analysis of the status of pathologic examinations considering the period between IR requests and inspection completions be made after at least 1 year.
Supplementary materials are available at Journal of Pathology and Translational Medicine (http://jpatholtm.org).
Fig. 1.
The kernel density estimation plot of each percentile inspection completion of insurance reimbursement requests (light gray, 33 percentile; dark gray, 66 percentile; black, 99 percentile).
jptm-2016-12-30f1.gif
Table 1.
Pathologic examination codes using in this study
Main category Subcategory Claim codes
Biopsy 1–3 pieces/4–6 pieces/7–9 pieces/10–12 pieces/more than 13 pieces C5911/C5912/C5913/C5914/C5915
Non-maligGro NPB ≤ 6/NPB ≥ 7 C5916/C5917
MaligGro LND NPB ≤ 20/NPB ≥ 21 C5918/C5919
MaligGro LNDX NPB ≤ 15/NPB ≥ 16 C5500/C5504
MAPPING LND/LNDX C5505/C5508
FS 1–2 specimens/3–6 specimens/7–10 specimens/equal and more than 11 specimens C5511/C5512/C5513/C5514
BONE - C5520
SPECIAL Reticulin/Massons’ Trichrome/others C5531/C5532/C5533
IF IgG/IgA/IgM/IgE/C3/C4/HBsAg/fibrinogen/others C5541/C5542/C5543/C5544/C5545/C5549/C5546/C5547/C5548
EM - C5550
ENZYME ATPase-pH 9.4/ATPase-pH 4.9/NADH/acetylcholinesterase/chloroacetate esterase/others C5561/C5562/C5563/C5564/C5565/C5566
Etc. Et cetera -
IHC Interpretation by qualified doctor C5575006
Interpretation by non-qualified doctor C5575
HR C5590
EGFR pharmDx kit CZ503006
Morphometric Analysis CY552
CERVIX Smear/L-based C5920/CX541
BFC General/using cytospin examination/L-based C5930/C5931/CZ521
AC Conventional/L-AC C5941/C5943
CB After BFC/after AC/L-AC C5940/C5942/C5944
HER2 (FISH) - C5967
HER2 (SISH) - CZ988
MSI test - CX574
OUTSIDE - Claim code + 009 (subnumber)

Non-maligGro, resected specimen requiring gross sectioning; NPB, number of paraffin blocks; MaligGro, resected specimen for malignant tumor requiring gross sectioning; LND, with lymph node dissection; LNDX, without lymph node dissection; MAPPING, histologic mapping of tumor; FS, emergency histopathologic examination during surgery; BONE, histopathologic examination for bone; SPECIAL, special stain examinations; IF, tissue immunofluorescent microscopic examination; EM, tissue electron microscopy; ENZYME, enzyme histochemistry; IHC, immunohisto(cyto)chemistry; HR, examination of hormone receptor in tissue; CERVIX, cervicovaginal cytopathology; L-, liquid based; BFC, body fluid cytopathology; AC, aspiration cytopathology; CB, cell block; HER2 (FISH), HER2 gene fluorescence in situ hybridization; HER2 (SISH), HER2 gene silver in situ hybridization; MSI, microsatellite instability; OUTSIDE, outside slide interpretation.

Table 2.
Annual pathologic examination status and trend
Main category 2011 2012 2013 2014 2015 Total Growth rates (%) by 2011 Slope Adjusted R-squared p-value
Biopsy 2,084,502 (20.24) 2,092,015 (20.31) 2,086,267 (20.25) 2,052,391 (19.92) 1,985,718 (19.28) 10,300,893 (100) –4.7 –23,719.2 .617 .072
Non-maligGro 1,269,834 (18.90) 1,371,044 (20.41) 1,349,030 (20.08) 1,340,151 (19.95) 1,388,338 (20.66) 6,718,397 (100) 9.3 20,611.5 .354 .172
MaligGro LND 100,204 (20.04) 106,599 (21.32) 107,083 (21.42) 97,288 (19.46) 88,838 (17.77) 500,012 (100) –11.3 –3,204.3 .273 .212
MaligGro LNDX 40,003 (18.99) 41,651 (19.77) 42,958 (20.39) 43,528 (20.66) 42,553 (20.20) 210,693 (100) 6.4 697.7 .524 .103
MAPPING 28,429 (15.16) 35,866 (19.12) 38,546 (20.55) 42,042 (22.42) 42,662 (22.75) 187,545 (100) 50.1 3,464.2 .867 .014
FS 111,477 (20.19) 116,373 (21.08) 114,943 (20.82) 107,726 (19.51) 101,583 (18.40) 552,102 (100) –8.9 –2,843.5 .424 .141
BONE 15,705 (21.11) 15,267 (20.52) 14,275 (19.19) 14,516 (19.51) 14,643 (19.68) 74,406 (100) –6.8 –287.5 .462 .126
SPECIAL 362,898 (19.53) 364,742 (19.63) 372,751 (20.07) 385,799 (20.77) 371,494 (20.00) 1,857,684 (100) 2.4 3,824.9 .266 .216
IF 59,173 (18.40) 63,043 (19.60) 64,959 (20.20) 66,347 (20.63) 68,110 (21.18) 321,632 (100) 15.1 2,117.8 .939 .004
EM 8,945 (19.07) 9,344 (19.92) 9,452 (20.15) 9,522 (20.30) 9,637 (20.55) 46,900 (100) 7.7 156.2 .821 .022
ENZYME 2,399 (27.80) 1,901 (22.03) 1,437 (16.65) 1,479 (17.14) 1,415 (16.39) 8,631 (100) –41 –239 .717 .044
IHC 550,773 (17.15) 610,637 (19.01) 653,438 (20.34) 698,083 (21.73) 699,285 (21.77) 3,212,216 (100) 27 38,447 .909 .008
CERVIX 209,750 (17.67) 224,052 (18.88) 226,773 (19.11) 245,152 (20.65) 281,166 (23.69) 1,186,893 (100) 34 16,393.2 .849 .017
BFC 490,524 (18.99) 514,410 (19.92) 511,839 (19.82) 530,399 (20.54) 535,708 (20.74) 2,582,880 (100) 9.2 10,635.7 .861 .015
AC 292,502 (21.91) 314,290 (23.55) 294,545 (22.07) 231,264 (17.33) 202,235 (15.15) 1,334,836 (100) –30.9 –26,356 .683 .053
CB 117,159 (21.76) 115,878 (21.52) 112,949 (20.98) 103,139 (19.15) 89,320 (16.59) 538,445 (100) –23.8 –6,841.7 .817 .023
HER2 0 (NA) 0 (NA) 1,176 (10.28) 5,031 (43.96) 5,238 (45.77) 11,445 (100) NA 1,550.7 .814 .023
MSI 11,837 (20.56) 10,763 (18.70) 10,831 (18.81) 11,919 (20.70) 12,219 (21.22) 57,569 (100) 3.2 192 –.060 .444
OUTSIDE 65,609 (18.04) 72,877 (20.04) 75,695 (20.81) 76,649 (21.07) 72,906 (20.04) 363,736 (100) 11.1 1,836.6 .267 .215

Values are presented as number (%).

Non-maligGro, resected specimen requiring gross sectioning; MaligGro, resected specimen for malignant tumor requiring gross sectioning; LND, with lymph node dissection; LNDX, without lymph node dissection; MAPPING, histologic mapping of tumor; FS, emergency histopathologic examination during surgery; BONE, histopathologic examination for bone; SPECIAL, special stain examinations; IF, tissue immunofluorescent microscopic examination; EM, tissue electron microscopy; ENZYME, enzyme histochemistry; IHC, immunohisto(cyto)chemistry; CERVIX, cervicovaginal cytopathology; BFC, body fluid cytopathology; AC, aspiration cytopathology; CB, cell block; HER2, HER2 gene fluorescence in situ hybridization and HER2 gene silver in situ hybridization; MSI, microsatellite instability; OUTSIDE, outside slide interpretation.

Table 3.
Pathologic examination numbers according to requesting department in 2011–2015: part I (sort based on department codes)
Requesting department Biopsy Non-maligGro MaligGro LND MaligGro LNDX MAPPING FS BONE SPECIAL IF EM
General 1,983 (0.02) 1,891 (0.03) 5 (<0.01) 2 (<0.01) 0 0 3 (<0.01) 74 (<0.01) 0 0
Internal medicine 6,743,794 (65.47) 2,094,401 (31.17) 10,822 (2.16) 12,804 (6.08) 101,570 (54.16) 17,044 (3.09) 36,536 (49.10) 1,347,183 (72.52) 219,154 (68.14) 30,851 (65.78)
Neurology 26,860 (0.26) 9,082 (0.14) 78 (0.02) 205 (0.10) 50 (0.03) 573 (0.10) 174 (0.23) 10,438 (0.56) 834 (0.26) 1,083 (2.31)
Psychiatry 7,026 (0.07) 1,895 (0.03) 11 (<0.01) 12 (0.01) 14 (0.01) 32 (0.01) 13 (0.02) 1,245 (0.07) 107 (0.03) 9 (0.02)
General surgery 1,309,516 (12.71) 1,679,607 (25.00) 379,207 (75.84) 73,301 (34.79) 57,975 (30.91) 298,270 (54.02) 406 (0.55) 193,095 (10.39) 36,140 (11.24) 5,525 (11.78)
Orthopedic surgery 128,100 (1.24) 452,910 (6.74) 649 (0.13) 6,321 (NA) 249 (0.13) 15,707 (2.84) 26,557 (35.69) 19,256 (1.04) 582 (0.18) 287 (0.61)
Neurosurgery 56,583 (0.55) 181,773 (2.71) 347 (0.07) 13,422 (6.37) 35 (0.02) 29,625 (5.37) 2,979 (NA) 18,216 (0.98) 673 (0.21) 3,672 (7.83)
Thoracic surgery 28,438 (0.28) 100,518 (1.50) 34,694 (6.94) 11,248 (5.34) 2,892 (1.54) 48,875 (8.85) 261 (0.35) 33,537 (1.81) 209 (0.06) 122 (0.26)
Plastic surgery 8,598 (0.08) 110,218 (1.64) 1,916 (0.38) 8,022 (3.81) 1,337 (0.71) 14,533 (2.63) 420 (0.56) 4,498 (0.24) 98 (0.03) 56 (0.12)
Anesthesiology 1,038 (0.01) 835 (0.01) 10 (<0.01) 8 (<0.01) 1 (<0.01) 20 (<0.01) 5 (0.01) 110 (0.01) 2 (<0.01) 0
Obstetrics and gynecology 888,109 (8.62) 1,078,597 (16.05) 26,431 (5.29) 16,294 (7.73) 4,194 (2.24) 43,154 (7.82) 53 (0.07) 16,801 (0.90) 136 (0.04) 152 (0.32)
Pediatrics 37,839 (0.37) 16,037 (0.24) 118 (0.02) 388 (0.18) 23 (0.01) 1,309 (0.24) 3,856 (5.18) 23,871 (1.28) 16,039 (4.99) 3,784 (8.07)
Ophthalmology 20,154 (0.20) 22,715 (0.34) 36 (0.01) 611 (0.29) 10 (0.01) 1,317 (0.24) 14 (0.02) 3,399 (0.18) 132 (0.04) 85 (0.18)
Otorhinolaryngology 123,136 (1.20) 396,701 (5.90) 31,590 (6.32) 17,180 (8.15) 464 (0.25) 50,489 (9.14) 148 (0.20) 46,797 (2.52) 254 (0.08) 197 (0.42)
Dermatology 340,839 (3.31) 222,969 (3.32) 121 (0.02) 4,481 (2.13) 472 (0.25) 5,487 (0.99) 9 (0.01) 80,731 (4.35) 41,682 (12.96) 70 (0.15)
Urology 286,191 (2.78) 215,571 (3.21) 12,449 (2.49) 45,382 (21.54) 17,938 (9.56) 22,137 (4.01) 70 (0.09) 15,361 (0.83) 1,916 (0.60) 542 (1.16)
Radiology 89,520 (0.87) 7,732 (0.12) 1 (<0.01) 2 (<0.01) 1 (<0.01) 4 (<0.01) 300 (0.40) 1,113 (0.06) 0 4 (0.01)
Radiation oncology 2,430 (0.02) 113 (<0.01) 0 0 0 1 (<0.01) 0 202 (0.01) 8 (<0.01) 1 (<0.01)
Pathology 391 (<0.01) 15 (<0.01) 0 0 0 3 (<0.01) 0 3,249 (0.17) 19 (0.01) 4 (0.01)
Laboratory medicine 338 (<0.01) 46 (<0.01) 0 0 0 0 24 (0.03) 921 (0.05) 0 1 (<0.01)
Tuberculosis 233 (<0.01) 20 (<0.01) 0 0 0 0 6 (0.01) 122 (0.01) 0 0
Rehabilitation medicine 8,784 (0.09) 4,392 (0.07) 37 (0.01) 181 (0.09) 30 (0.02) 385 (0.07) 104 (0.14) 2,131 (0.11) 500 (0.16) 135 (0.29)
Nuclear medicine 118 (<0.01) 15 (<0.01) 0 0 1 (<0.01) 0 0 82 (<0.01) 0 0
Family medicine 146,907 (1.43) 49,855 (0.74) 31 (0.01) 17 (0.01) 240 (0.13) 62 (0.01) 23 (0.03) 26,784 (1.44) 263 (0.08) 10 (0.02)
Emergency medicine 15,072 (0.15) 6,035 (0.09) 166 (0.03) 190 (0.09) 41 (0.02) 276 (0.05) 97 (0.13) 5,778 (0.31) 1,381 (0.43) 309 (0.66)
Occupational and environmental medicine 1,876 (0.02) 98 (<0.01) 0 0 0 0 1 (<0.01) 63 (<0.01) 0 0
Preventive medicine 1,394 (0.01) 4,229 (0.06) 0 0 2 (<0.01) 0 0 3 (<0.01) 0 0
Dental department 25,596 (0.25) 60,112 (0.89) 1,293 (0.26) 622 (0.30) 6 (<0.01) 2,799 (0.51) 2,347 (3.15) 2,624 (0.14) 1,503 (0.47) 1 (<0.01)
Etc. 30 (<0.01) 15 (<0.01) 0 0 0 0 0 0 0 0
Summary 10,300,893 (100) 6,718,397 (100) 500,012 (100) 210,693 (100) 187,545 (100) 552,102 (100) 74,406 (100) 1,857,684 (100) 321,632 (100) 46,900 (100)

Values are presented as number (%).

Non-maligGro, resected specimen requiring gross sectioning; MaligGro, resected specimen for malignant tumor requiring gross sectioning; LND, with lymph node dissection; LNDX, without lymph node dissection; MAPPING, histologic mapping of tumor; FS, emergency histopathologic examination during surgery; BONE, histopathologic examination for bone; SPECIAL, special stain examinations; IF, tissue immunofluorescent microscopic examination; EM, tissue electron microscopy

Table 4.
Pathologic examination numbers according to requesting department in 2011–2015: part II (sort based on department codes)
Requesting department ENZYME IHC CERVIX BFC AC CB HER2 MSI OUTSIDE Summary
General 0 5 (<0.01) 363 (0.03) 275 (0.01) 846 (0.06) 13 (<0.01) 1 (0.01) 0 0 5,461 (0.02)
Internal medicine 2,324 (26.93) 897,900 (27.95) 36,501 (3.08) 1,259,857 (48.78) 622,477 (46.63) 369,897 (68.70) 2,622 (22.91) 3,317 (5.76) 108,745 (29.90) 13,917,799 (46.29)
Neurology 2,312 (26.79) 5,100 (0.16) 1,412 (0.12) 53,245 (2.06) 2,423 (0.18) 1,852 (0.34) 5 (0.04) 8 (0.01) 148 (0.04) 115,882 (0.39)
Psychiatry 8 (0.09) 391 (0.01) 666 (0.06) 2,330 (0.09) 435 (0.03) 153 (0.03) 1 (0.01) 2 (<0.01) 24 (0.01) 14,374 (0.05)
General surgery 139 (1.61) 1,413,101 (43.99) 6,204 (0.52) 104,518 (4.05) 489,190 (36.65) 49,603 (9.21) 8,311 (72.62) 53,777 (93.41) 177,028 (48.67) 6,334,913 (21.07)
Orthopedic surgery 321 (3.72) 34,131 (1.06) 3,285 (0.28) 35,414 (1.37) 12,788 (0.96) 3,055 (0.57) 13 (0.11) 7 (0.01) 3,004 (0.83) 742,636 (2.47)
Neurosurgery 186 (2.16) 95,260 (2.97) 1,915 (0.16) 35,088 (1.36) 3,349 (0.25) 2,957 (0.55) 23 (0.20) 8 (0.01) 825 (0.23) 446,936 (1.49)
Thoracic surgery 6 (0.07) 91,268 (2.84) 314 (0.03) 42,808 (1.66) 3,034 (0.23) 13,872 (2.58) 30 (0.26) 92 (0.16) 7,707 (2.12) 419,925 (1.40)
Plastic surgery 91 (1.05) 24,684 (0.77) 107 (0.01) 991 (0.04) 482 (0.04) 388 (0.07) 130 (1.14) 2 (<0.01) 1,254 (0.34) 177,825 (0.59)
Anesthesiology 0 58 (<0.01) 70 (0.01) 371 (0.01) 135 (0.01) 31 (0.01) 0 0 5 (<0.01) 2,699 (0.01)
Obstetrics and gynecology 17 (0.20) 152,242 (4.74) 1,099,372 (92.63) 56,916 (2.20) 28,236 (2.12) 14,401 (2.67) 21 (0.18) 203 (0.35) 19,467 (5.35) 3,444,796 (11.46)
Pediatrics 2,489 (28.84) 31,051 (0.97) 116 (0.01) 38,929 (1.51) 1,821 (0.14) 1,494 (0.28) 0 4 (0.01) 1,258 (0.35) 180,426 (0.60)
Ophthalmology 63 (0.73) 10,629 (0.33) 59 (<0.01) 1,608 (0.06) 848 (0.06) 364 (0.07) 1 (0.01) 0 384 (0.11) 62,429 (0.21)
Otorhinolaryngology 4 (0.05) 125,340 (3.90) 460 (0.04) 9,871 (0.38) 83,493 (6.25) 27,339 (5.08) 1 (0.01) 7 (0.01) 21,799 (5.99) 935,270 (3.11)
Dermatology 197 (2.28) 77,791 (2.42) 308 (0.03) 4,179 (0.16) 3,150 (0.24) 219 (0.04) 7 (0.06) 0 4,957 (1.36) 787,669 (2.62)
Urology 9 (0.10) 193,693 (6.03) 26,181 (2.21) 876,070 (33.92) 31,351 (2.35) 11,392 (2.12) 4 (0.03) 24 (0.04) 13,370 (3.68) 1,769,651 (5.89)
Radiology 2 (0.02) 33,526 (1.04) 298 (0.03) 1,356 (0.05) 31,699 (2.37) 23,850 (4.43) 254 (2.22) 1 (<0.01) 856 (0.24) 190,519 (0.63)
Radiation oncology 0 915 (0.03) 3,773 (0.32) 100 (<0.01) 155 (0.01) 256 (0.05) 1 (0.01) 9 (0.02) 1,367 (0.38) 9,331 (0.03)
Pathology 1 (0.01) 81 (<0.01) 1 (<0.01) 206 (0.01) 3,255 (0.24) 3,488 (0.65) 1 (0.01) 0 10 (<0.01) 10,724 (0.04)
Laboratory medicine 0 7,006 (0.22) 112 (0.01) 22 (<0.01) 5 (<0.01) 2 (<0.01) 0 0 3 (<0.01) 8,480 (0.03)
Tuberculosis 0 75 (<0.01) 10 (<0.01) 1,276 (0.05) 43 (<0.01) 87 (0.02) 0 0 61 (0.02) 1,933 (0.01)
Rehabilitation medicine 392 (4.54) 1,884 (0.06) 648 (0.05) 6,636 (0.26) 606 (0.05) 940 (0.17) 10 (0.09) 8 (0.01) 65 (0.02) 27,868 (0.09)
Nuclear medicine 0 62 (<0.01) 7 (<0.01) 44 (<0.01) 2,514 (0.19) 682 (0.13) 0 0 58 (0.02) 3,583 (0.01)
Family medicine 5 (0.06) 3,524 (0.11) 2,536 (0.21) 16,582 (0.64) 11,341 (0.85) 4,132 (0.77) 1 (0.01) 5 (0.01) 398 (0.11) 262,716 (0.87)
Emergency medicine 64 (0.74) 3,939 (0.12) 2,156 (0.18) 31,115 (1.20) 514 (0.04) 7,460 (1.39) 8 (0.07) 95 (0.17) 293 (0.08) 74,989 (0.25)
Occupational and environmental medicine 0 18 (<0.01) 1 (<0.01) 159 (0.01) 81 (0.01) 2 (<0.01) 0 0 1 (<0.01) 2,300 (0.01)
Preventive medicine 0 5 (<0.01) 2 (<0.01) 24 (<0.01) 188 (0.01) 0 0 0 1 (<0.01) 5,848 (0.02)
Dental department 1 (0.01) 8,537 (0.27) 15 (<0.01) 2,875 (0.11) 372 (0.03) 516 (0.10) 0 0 648 (0.18) 109,867 (0.37)
Etc. 0 0 1 (<0.01) 15 (<0.01) 5 (<0.01) 0 0 0 0 66 (<0.01)
Summary 8,631 (100) 3,212,216 (100) 1,186,893 (100) 2,582,880 (100) 1,334,836 (100) 538,445 (100) 11,445 (100) 57,569 (100) 363,736 (100) 30,066,915 (100)

Values are presented as number (%).

ENZYME, enzyme histochemistry; IHC, immunohisto(cyto)chemistry; CERVIX, cervicovaginal cytopathology; BFC, body fluid cytopathology; AC, aspiration cytopathology; CB, cell block; HER2, HER2 gene fluorescence in situ hybridization and HER2 gene silver in situ hybridization; MSI, microsatellite instability; OUTSIDE, outside slide interpretation.

Table 5.
Pathologic examination status according to types of medical institutions in 2011–2015
Pathologic examination Tertiary hospital General hospital Hospital Convalescent hospital Clinic Dental hospital Dental clinic Public health center Public health center and county hospital Oriental hospital Summary
Biopsy 2,354,632 (22.86) 2,617,426 (25.41) 1,387,062 (13.47) 13,460 (0.13) 3,910,624 (37.96) 13,285 (0.13) 898 (0.01) 0 2,767 (0.03) 739 (0.01) 10,300,893 (100)
Non-maligGro 1,727,593 (25.71) 2,362,797 (35.17) 1,161,784 (17.29) 3,929 (0.06) 1,440,209 (21.44) 18,397 (0.27) 384 (0.01) 0 2,197 (0.03) 1,107 (0.02) 6,718,397 (100)
MaligGro LND 332,395 (66.48) 149,342 (29.87) 13,548 (2.71) 2 (<0.01) 4,032 (0.81) 693 (0.14) 0 0 0 0 500,012 (100)
MaligGro LNDX 151,392 (71.85) 56,436 (26.79) 1,999 (0.95) 16 (0.01) 567 (0.27) 282 (0.13) 0 0 1 (<0.01) 0 210,693 (100)
MAPPING 132,776 (70.80) 52,851 (28.18) 1,705 (0.91) 7 (<0.01) 205 (0.11) 1 (<0.01) 0 0 0 0 187,545 (100)
FS 388,171 (70.31) 158,797 (28.76) 3,730 (0.68) 21 (<0.01) 104 (0.02) 1,279 (0.23) 0 0 0 0 552,102 (100)
BONE 35,926 (48.28) 27,499 (36.96) 9,264 (12.45) 5 (0.01) 333 (0.45) 1,378 (1.85) 1 (<0.01) 0 0 0 74,406 (100)
SPECIAL 817,633 (44.01) 756,183 (40.71) 57,218 (3.08) 778 (0.04) 224,562 (12.09) 1,301 (0.07) 0 0 1 (<0.01) 8 (<0.01) 1,857,684 (100)
IF 226,147 (70.31) 91,857 (28.56) 519 (0.16) 503 (0.16) 1,450 (0.45) 1,156 (0.36) 0 0 0 0 321,632 (100)
EM 35,284 (75.23) 11,411 (24.33) 61 (0.13) 0 144 (0.31) 0 0 0 0 0 46,900 (100)
ENZYME 7,524 (87.17) 1,093 (12.66) 9 (0.10) 0 5 (0.06) 0 0 0 0 0 8,631 (100)
IHC 2,205,781 (68.67) 966,307 (30.08) 25,241 (0.79) 351 (0.01) 9,041 (0.28) 5,481 (0.17) 0 0 12 (<0.01) 2 (<0.01) 3,212,216 (100)
CERVIX 490,880 (41.36) 449,685 (37.89) 70,512 (5.94) 592 (0.05) 174,700 (14.72) 0 0 3 (<0.01) 503 (0.04) 18 (<0.01) 1,186,893 (100)
BFC 1,201,031 (46.50) 1,053,678 (40.79) 162,061 (6.27) 2,248 (0.09) 161,414 (6.25) 2,319 (0.09) 0 0 106 (<0.01) 23 (<0.01) 2,582,880 (100)
AC 219,121 (16.42) 335,929 (25.17) 152,361 (11.41) 645 (0.05) 626,573 (46.94) 145 (0.01) 1 (<0.01) 0 32 (<0.01) 29 (<0.01) 1,334,836 (100)
CB 293,874 (54.58) 196,885 (36.57) 20,101 (3.73) 124 (0.02) 27,092 (5.03) 369 (0.07) 0 0 0 0 538,445 (100)
HER2 8,605 (75.19) 2,747 (24.00) 86 (0.75) 6 (0.05) 1 (0.01) 0 0 0 0 0 11,445 (100)
MSI 49,100 (85.29) 8,318 (14.45) 151 (0.26) 0 0 0 0 0 0 0 57,569 (100)
OUTSIDE 276,885 (76.12) 75,385 (20.73) 1,391 (0.38) 47 (0.01) 9,667 (2.66) 360 (0.10) 0 0 0 1 (<0.01) 363,736 (100)
Summary 10,954,750 (36.43) 9,374,626 (31.18) 3,068,803 (10.21) 22,734 (0.08) 6,590,723 (21.92) 46,446 (0.15) 1,284 (<0.01) 3 (<0.01) 5,619 (0.02) 1,927 (0.01) 30,066,915 (100)

Values are presented as number (%).

Non-maligGro, resected specimen requiring gross sectioning; MaligGro, resected specimen for malignant tumor requiring gross sectioning; LND, with lymph node dissection; LNDX, without lymph node dissection; MAPPING, histologic mapping of tumor; FS, emergency histopathologic examination during surgery; BONE, histopathologic examination for bone; SPECIAL, special stain examinations; IF, tissue immunofluorescent microscopic examination; EM, tissue electron microscopy; ENZYME, enzyme histochemistry; IHC, immunohisto(cyto)chemistry; CERVIX, cervicovaginal cytopathology; BFC, body fluid cytopathology; AC, aspiration cytopathology; CB, cell block; HER2, HER2 gene fluorescence in situ hybridization and HER2 gene silver in situ hybridization; MSI, microsatellite instability; OUTSIDE, outside slide interpretation.

Table 6.
Pathologic examination status according to administrative districts in 2011–2015: part I (sort based on administrative districts codes)
Administrative district Biopsy Non-maligGro MaligGro LND MaligGro LNDX MAPPING FS BONE SPECIAL IF EM
Etc. 0 21 (<0.01) 0 0 0 0 0 0 0 0
Seoul 3,569,090 (30.24) 2,487,048 (32.18) 267,423 (46.34) 113,181 (46.84) 109,012 (50.46) 317,546 (49.92) 22,231 (27.33) 830,214 (37.57) 169,672 (46.92) 26,715 (51.53)
Busan 1,007,783 (8.54) 718,747 (9.30) 57,598 (9.98) 26,132 (10.81) 18,263 (8.45) 61,611 (9.69) 9,156 (11.25) 101,122 (4.58) 39,230 (10.85) 5,599 (10.80)
Incheon 701,281 (5.94) 457,064 (5.91) 42,029 (7.28) 20,095 (8.32) 12,743 (5.90) 41,553 (6.53) 5,388 (6.62) 158,767 (7.18) 18,329 (5.07) 1,915 (3.69)
Daegu 914,814 (7.75) 505,092 (6.54) 43,935 (7.61) 13,662 (5.65) 9,264 (4.29) 35,356 (5.56) 10,090 (12.40) 161,162 (7.29) 22,793 (6.30) 3,466 (6.68)
Gwangju 419,909 (3.56) 314,418 (4.07) 9,260 (1.60) 2,575 (1.07) 1,216 (0.56) 7,133 (1.12) 635 (0.78) 31,555 (1.43) 6,476 (1.79) 1,167 (2.25)
Daejeon 435,340 (3.69) 309,986 (4.01) 19,421 (3.37) 3,075 (1.27) 3,934 (1.82) 13,359 (2.10) 6,968 (8.56) 66,516 (3.01) 12,276 (3.39) 1,732 (3.34)
Ulsan 250,163 (2.12) 168,514 (2.18) 8,207 (1.42) 4,827 (2.00) 138 (0.06) 8,178 (1.29) 2,136 (2.63) 41,843 (1.89) 6,577 (1.82) 698 (1.35)
Gyeonggi-do 1,978,367 (16.76) 1,287,772 (16.66) 67,488 (11.70) 28,882 (11.95) 37,470 (17.35) 78,222 (12.30) 11,599 (14.26) 436,544 (19.75) 49,950 (13.81) 5,760 (11.11)
Gangwon-do 228,857 (1.94) 150,249 (1.94) 6,447 (1.12) 3,586 (1.48) 4,503 (2.08) 10,730 (1.69) 3,151 (3.87) 67,670 (3.06) 7,882 (2.18) 758 (1.46)
Chungcheongbuk-do 250,413 (2.12) 171,847 (2.22) 5,083 (0.88) 1,591 (0.66) 590 (0.27) 5,706 (0.90) 1,927 (2.37) 61,513 (2.78) 2,266 (0.63) 385 (0.74)
Chungcheongnam-do 313,423 (2.66) 155,444 (2.01) 5,393 (0.93) 2,529 (1.05) 3,700 (1.71) 6,237 (0.98) 177 (0.22) 41,352 (1.87) 6,644 (1.84) 727 (1.40)
Jeollabuk-do 349,185 (2.96) 192,196 (2.49) 11,396 (1.97) 7,030 (2.91) 4,207 (1.95) 14,340 (2.25) 3,226 (3.97) 20,504 (0.93) 3,829 (1.06) 458 (0.88)
Jeollanam-do 295,622 (2.50) 177,955 (2.30) 16,774 (2.91) 7,613 (3.15) 30 (0.01) 11,400 (1.79) 245 (0.30) 35,185 (1.59) 1,056 (0.29) 200 (0.39)
Gyeongsangbuk-do 451,285 (3.82) 220,085 (2.85) 1,936 (0.34) 816 (0.34) 1,159 (0.54) 1,852 (0.29) 1,028 (1.26) 44,136 (2.00) 2,140 (0.59) 270 (0.52)
Gyeongsangnam-do 532,322 (4.51) 352,022 (4.55) 12,136 (2.10) 5,078 (2.10) 8,698 (4.03) 19,881 (3.13) 2,205 (2.71) 78,121 (3.54) 9,437 (2.61) 1,572 (3.03)
Jeju 100,466 (0.85) 57,359 (0.74) 2,538 (0.44) 961 (0.40) 1,094 (0.51) 3,023 (0.48) 1,194 (1.47) 33,540 (1.52) 3,070 (0.85) 426 (0.82)
Sejong-si 4,372 (0.04) 3,023 (0.04) 0 0 0 0 0 104 (<0.01) 0 0
Summary 11,802,692 (100) 7,728,842 (100) 577,064 (100) 241,633 (100) 216,021 (100) 636,127 (100) 81,356 (100) 2,209,848 (100) 361,627 (100) 51,848 (100)

Values are presented as number (%).

Non-maligGro, resected specimen requiring gross sectioning; MaligGro, resected specimen for malignant tumor requiring gross sectioning; LND, with lymph node dissection; LNDX, without lymph node dissection; MAPPING, histologic mapping of tumor; FS, emergency histopathologic examination during surgery; BONE, histopathologic examination for bone; SPECIAL, special stain examinations; IF, tissue immunofluorescent microscopic examination; EM, tissue electron microscopy.

Table 7.
Pathologic examination status according to administrative districts in 2011–2015: part II (sort based on administrative districts codes)
Administrative district ENZYME IHC CERVIX BFC AC CB HER2 MSI OUTSIDE Summary
Etc. 0 0 0 0 0 0 0 0 0 21 (<0.01)
Seoul 6,622 (71.09) 1,767,200 (46.85) 543,513 (40.40) 1,146,492 (39.19) 338,246 (22.66) 273,523 (44.02) 6,944 (52.83) 36,679 (55.68) 261,862 (61.69) 12,293,213 (35.55)
Busan 521 (5.59) 309,799 (8.21) 106,119 (7.89) 307,125 (10.50) 184,239 (12.34) 42,686 (6.87) 898 (6.83) 6,723 (10.21) 24,460 (5.76) 3,027,811 (8.76)
Incheon 144 (1.55) 234,731 (6.22) 86,153 (6.40) 235,529 (8.05) 92,453 (6.19) 38,392 (6.18) 1,297 (9.87) 4,462 (6.77) 19,867 (4.68) 2,172,192 (6.28)
Daegu 501 (5.38) 402,725 (10.68) 88,991 (6.62) 131,159 (4.48) 150,027 (10.05) 64,550 (10.39) 815 (6.20) 3,096 (4.70) 22,940 (5.40) 2,584,438 (7.47)
Gwangju 136 (1.46) 36,164 (0.96) 38,359 (2.85) 74,981 (2.56) 133,266 (8.93) 4,443 (0.72) 27 (0.21) 0 1,441 (0.34) 1,083,161 (3.13)
Daejeon 53 (0.57) 71,899 (1.91) 40,038 (2.98) 83,455 (2.85) 45,632 (3.06) 7,065 (1.14) 194 (1.48) 36 (0.05) 9,240 (2.18) 1,130,219 (3.27)
Ulsan 4 (0.04) 46,112 (1.22) 18,427 (1.37) 53,310 (1.82) 30,219 (2.02) 8,665 (1.39) 153 (1.16) 2 (<0.01) 3,367 (0.79) 651,540 (1.88)
Gyeonggi-do 849 (9.11) 569,103 (15.09) 219,328 (16.30) 374,113 (12.79) 221,132 (14.81) 92,707 (14.92) 1,820 (13.85) 10,526 (15.98) 58,704 (13.83) 5,530,336 (15.99)
Gangwon-do 24 (0.26) 63,272 (1.68) 35,913 (2.67) 69,897 (2.39) 15,218 (1.02) 17,189 (2.77) 208 (1.58) 624 (0.95) 1,517 (0.36) 687,695 (1.99)
Chungcheongbuk-do 0 13,816 (0.37) 11,057 (0.82) 45,783 (1.56) 30,046 (2.01) 8,844 (1.42) 55 (0.42) 371 (0.56) 2,802 (0.66) 614,095 (1.78)
Chungcheongnam-do 6 (0.06) 26,956 (0.71) 29,260 (2.18) 56,711 (1.94) 23,501 (1.57) 17,295 (2.78) 167 (1.27) 0 2,420 (0.57) 691,942 (2.00)
Jeollabuk-do 8 (0.09) 71,973 (1.91) 28,958 (2.15) 93,002 (3.18) 54,035 (3.62) 2,377 (0.38) 150 (1.14) 259 (0.39) 3,424 (0.81) 860,557 (2.49)
Jeollanam-do 3 (0.03) 55,684 (1.48) 27,585 (2.05) 55,997 (1.91) 68,206 (4.57) 5,211 (0.84) 285 (2.17) 798 (1.21) 6,128 (1.44) 765,977 (2.22)
Gyeongsangbuk-do 10 (0.11) 8,784 (0.23) 26,061 (1.94) 58,344 (1.99) 41,342 (2.77) 6,361 (1.02) 7 (0.05) 1 (<0.01) 330 (0.08) 865,947 (2.50)
Gyeongsangnam-do 339 (3.64) 70,854 (1.88) 30,645 (2.28) 109,302 (3.74) 54,687 (3.66) 29,855 (4.80) 92 (0.70) 2,266 (3.44) 5,066 (1.19) 1,324,578 (3.83)
Jeju 95 (1.02) 22,901 (0.61) 14,340 (1.07) 30,246 (1.03) 10,421 (0.70) 2,217 (0.36) 33 (0.25) 36 (0.05) 933 (0.22) 284,893 (0.82)
Sejong-si 0 5 (<0.01) 484 (0.04) 129 (<0.01) 331 (0.02) 12 (<0.01) 0 0 2 (<0.01) 8,462 (0.02)
Summary 9,315 (100) 3,771,978 (100) 1,345,231 (100) 2,925,575 (100) 1,493,001 (100) 621,392 (100) 13,145 (100) 65,879 (100) 424,503 (100) 34,577,077 (100)

Values are presented as number (%).

ENZYME, enzyme histochemistry; IHC, immunohisto(cyto)chemistry; CERVIX, cervicovaginal cytopathology; BFC, body fluid cytopathology; AC, aspiration cytopathology; CB, cell block; HER2, HER2 gene fluorescence in situ hybridization and HER2 gene silver in situ hybridization; MSI, microsatellite instability; OUTSIDE, outside slide interpretation.

Table 8.
Summary of the types of institutions where pathologic examinations were done during 2011.2015
Pathologic examination Performed in their own hospitals Performed using outside services Convalescent hospital Etc. Summary
Biopsy 4,484,330 (43.53) 5,784,009 (56.15) 28,542 (0.28) 4,012 (0.04) 10,300,893 (100)
Non-maligGro 3,621,714 (53.91) 3,034,515 (45.17) 61,635 (0.92) 533 (0.01) 6,718,397 (100)
MaligGro LND 475,825 (95.16) 20,673 (4.13) 3,512 (0.70) 2 (<0.01) 500,012 (100)
MaligGro LNDX 206,618 (98.07) 3,252 (1.54) 821 (0.39) 2 (<0.01) 210,693 (100)
MAPPING 185,267 (98.79) 1,123 (0.60) 1,152 (0.61) 3 (<0.01) 187,545 (100)
FS 545,200 (98.75) 4,089 (0.74) 2,806 (0.51) 7 (<0.01) 552,102 (100)
BONE 58,330 (78.39) 13,576 (18.25) 2,496 (3.35) 4 (0.01) 74,406 (100)
SPECIAL 1,487,782 (80.09) 363,521 (19.57) 5,793 (0.31) 588 (0.03) 1,857,684 (100)
IF 259,628 (80.72) 58,684 (18.25) 3,317 (1.03) 3 (<0.01) 321,632 (100)
EM 31,593 (67.36) 15,175 (32.36) 132 (0.28) 0 46,900 (100)
ENZYME 7,779 (90.13) 787 (9.12) 65 (0.75) 0 8,631 (100)
IHC 3,129,765 (97.43) 62,839 (1.96) 19,503 (0.61) 109 (<0.01) 3,212,216 (100)
CERVIX 901,312 (75.94) 278,397 (23.46) 1,057 (0.09) 6,127 (0.52) 1,186,893 (100)
BFC 2,068,613 (80.09) 490,820 (19.00) 22,888 (0.89) 559 (0.02) 2,582,880 (100)
AC 458,090 (34.32) 855,980 (64.13) 489 (0.04) 20,277 (1.52) 1,334,836 (100)
CB 505,034 (93.79) 29,688 (5.51) 3,073 (0.57) 650 (0.12) 538,445 (100)
HER2 9,856 (86.12) 1,587 (13.87) 2 (0.02) 0 11,445 (100)
MSI 35,244 (61.22) 22,325 (38.78) 0 0 57,569 (100)
OUTSIDE 356,892 (98.12) 6,640 (1.83) 165 (0.05) 39 (0.01) 363,736 (100)
Summary 18,828,872 (62.62) 11,047,680 (36.74) 157,448 (0.52) 32,915 (0.11) 30,066,915 (100)

Values are presented as number (%).

Non-maligGro, resected specimen requiring gross sectioning; MaligGro, resected specimen for malignant tumor requiring gross sectioning; LND, with lymph node dissection; LNDX, without lymph node dissection; MAPPING, histologic mapping of tumor; FS, emergency histopathologic examination during surgery; BONE, histopathologic examination for bone; SPECIAL, special stain examinations; IF, tissue immunofluorescent microscopic examination; EM, tissue electron microscopy; ENZYME, enzyme histochemistry; IHC, immunohisto(cyto)chemistry; CERVIX, cervicovaginal cytopathology; BFC, body fluid cytopathology; AC, aspiration cytopathology; CB, cell block; HER2, HER2 gene fluorescence in situ hybridization and HER2 gene silver in situ hybridization; MSI, microsatellite instability; OUTSIDE, outside slide interpretation.

  • 1. Byeon SJ, Kim WH. Analysis of surgical pathology data in the HIRA database: emphasis on current status and endoscopic submucosal dissection specimens. J Pathol Transl Med 2016; 50: 204-10. ArticlePubMedPMCPDF
  • 2. Kim L, Kim JA, Kim S. A guide for the utilization of Health Insurance Review and Assessment Service National Patient Samples. Epidemiol Health 2014; 36: e2014008. ArticlePDF

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    Current Status of Pathologic Examinations in Korea, 2011–2015, Based on the Health Insurance Review and Assessment Service Dataset
    Image
    Fig. 1. The kernel density estimation plot of each percentile inspection completion of insurance reimbursement requests (light gray, 33 percentile; dark gray, 66 percentile; black, 99 percentile).
    Current Status of Pathologic Examinations in Korea, 2011–2015, Based on the Health Insurance Review and Assessment Service Dataset
    Main category Subcategory Claim codes
    Biopsy 1–3 pieces/4–6 pieces/7–9 pieces/10–12 pieces/more than 13 pieces C5911/C5912/C5913/C5914/C5915
    Non-maligGro NPB ≤ 6/NPB ≥ 7 C5916/C5917
    MaligGro LND NPB ≤ 20/NPB ≥ 21 C5918/C5919
    MaligGro LNDX NPB ≤ 15/NPB ≥ 16 C5500/C5504
    MAPPING LND/LNDX C5505/C5508
    FS 1–2 specimens/3–6 specimens/7–10 specimens/equal and more than 11 specimens C5511/C5512/C5513/C5514
    BONE - C5520
    SPECIAL Reticulin/Massons’ Trichrome/others C5531/C5532/C5533
    IF IgG/IgA/IgM/IgE/C3/C4/HBsAg/fibrinogen/others C5541/C5542/C5543/C5544/C5545/C5549/C5546/C5547/C5548
    EM - C5550
    ENZYME ATPase-pH 9.4/ATPase-pH 4.9/NADH/acetylcholinesterase/chloroacetate esterase/others C5561/C5562/C5563/C5564/C5565/C5566
    Etc. Et cetera -
    IHC Interpretation by qualified doctor C5575006
    Interpretation by non-qualified doctor C5575
    HR C5590
    EGFR pharmDx kit CZ503006
    Morphometric Analysis CY552
    CERVIX Smear/L-based C5920/CX541
    BFC General/using cytospin examination/L-based C5930/C5931/CZ521
    AC Conventional/L-AC C5941/C5943
    CB After BFC/after AC/L-AC C5940/C5942/C5944
    HER2 (FISH) - C5967
    HER2 (SISH) - CZ988
    MSI test - CX574
    OUTSIDE - Claim code + 009 (subnumber)
    Main category 2011 2012 2013 2014 2015 Total Growth rates (%) by 2011 Slope Adjusted R-squared p-value
    Biopsy 2,084,502 (20.24) 2,092,015 (20.31) 2,086,267 (20.25) 2,052,391 (19.92) 1,985,718 (19.28) 10,300,893 (100) –4.7 –23,719.2 .617 .072
    Non-maligGro 1,269,834 (18.90) 1,371,044 (20.41) 1,349,030 (20.08) 1,340,151 (19.95) 1,388,338 (20.66) 6,718,397 (100) 9.3 20,611.5 .354 .172
    MaligGro LND 100,204 (20.04) 106,599 (21.32) 107,083 (21.42) 97,288 (19.46) 88,838 (17.77) 500,012 (100) –11.3 –3,204.3 .273 .212
    MaligGro LNDX 40,003 (18.99) 41,651 (19.77) 42,958 (20.39) 43,528 (20.66) 42,553 (20.20) 210,693 (100) 6.4 697.7 .524 .103
    MAPPING 28,429 (15.16) 35,866 (19.12) 38,546 (20.55) 42,042 (22.42) 42,662 (22.75) 187,545 (100) 50.1 3,464.2 .867 .014
    FS 111,477 (20.19) 116,373 (21.08) 114,943 (20.82) 107,726 (19.51) 101,583 (18.40) 552,102 (100) –8.9 –2,843.5 .424 .141
    BONE 15,705 (21.11) 15,267 (20.52) 14,275 (19.19) 14,516 (19.51) 14,643 (19.68) 74,406 (100) –6.8 –287.5 .462 .126
    SPECIAL 362,898 (19.53) 364,742 (19.63) 372,751 (20.07) 385,799 (20.77) 371,494 (20.00) 1,857,684 (100) 2.4 3,824.9 .266 .216
    IF 59,173 (18.40) 63,043 (19.60) 64,959 (20.20) 66,347 (20.63) 68,110 (21.18) 321,632 (100) 15.1 2,117.8 .939 .004
    EM 8,945 (19.07) 9,344 (19.92) 9,452 (20.15) 9,522 (20.30) 9,637 (20.55) 46,900 (100) 7.7 156.2 .821 .022
    ENZYME 2,399 (27.80) 1,901 (22.03) 1,437 (16.65) 1,479 (17.14) 1,415 (16.39) 8,631 (100) –41 –239 .717 .044
    IHC 550,773 (17.15) 610,637 (19.01) 653,438 (20.34) 698,083 (21.73) 699,285 (21.77) 3,212,216 (100) 27 38,447 .909 .008
    CERVIX 209,750 (17.67) 224,052 (18.88) 226,773 (19.11) 245,152 (20.65) 281,166 (23.69) 1,186,893 (100) 34 16,393.2 .849 .017
    BFC 490,524 (18.99) 514,410 (19.92) 511,839 (19.82) 530,399 (20.54) 535,708 (20.74) 2,582,880 (100) 9.2 10,635.7 .861 .015
    AC 292,502 (21.91) 314,290 (23.55) 294,545 (22.07) 231,264 (17.33) 202,235 (15.15) 1,334,836 (100) –30.9 –26,356 .683 .053
    CB 117,159 (21.76) 115,878 (21.52) 112,949 (20.98) 103,139 (19.15) 89,320 (16.59) 538,445 (100) –23.8 –6,841.7 .817 .023
    HER2 0 (NA) 0 (NA) 1,176 (10.28) 5,031 (43.96) 5,238 (45.77) 11,445 (100) NA 1,550.7 .814 .023
    MSI 11,837 (20.56) 10,763 (18.70) 10,831 (18.81) 11,919 (20.70) 12,219 (21.22) 57,569 (100) 3.2 192 –.060 .444
    OUTSIDE 65,609 (18.04) 72,877 (20.04) 75,695 (20.81) 76,649 (21.07) 72,906 (20.04) 363,736 (100) 11.1 1,836.6 .267 .215
    Requesting department Biopsy Non-maligGro MaligGro LND MaligGro LNDX MAPPING FS BONE SPECIAL IF EM
    General 1,983 (0.02) 1,891 (0.03) 5 (<0.01) 2 (<0.01) 0 0 3 (<0.01) 74 (<0.01) 0 0
    Internal medicine 6,743,794 (65.47) 2,094,401 (31.17) 10,822 (2.16) 12,804 (6.08) 101,570 (54.16) 17,044 (3.09) 36,536 (49.10) 1,347,183 (72.52) 219,154 (68.14) 30,851 (65.78)
    Neurology 26,860 (0.26) 9,082 (0.14) 78 (0.02) 205 (0.10) 50 (0.03) 573 (0.10) 174 (0.23) 10,438 (0.56) 834 (0.26) 1,083 (2.31)
    Psychiatry 7,026 (0.07) 1,895 (0.03) 11 (<0.01) 12 (0.01) 14 (0.01) 32 (0.01) 13 (0.02) 1,245 (0.07) 107 (0.03) 9 (0.02)
    General surgery 1,309,516 (12.71) 1,679,607 (25.00) 379,207 (75.84) 73,301 (34.79) 57,975 (30.91) 298,270 (54.02) 406 (0.55) 193,095 (10.39) 36,140 (11.24) 5,525 (11.78)
    Orthopedic surgery 128,100 (1.24) 452,910 (6.74) 649 (0.13) 6,321 (NA) 249 (0.13) 15,707 (2.84) 26,557 (35.69) 19,256 (1.04) 582 (0.18) 287 (0.61)
    Neurosurgery 56,583 (0.55) 181,773 (2.71) 347 (0.07) 13,422 (6.37) 35 (0.02) 29,625 (5.37) 2,979 (NA) 18,216 (0.98) 673 (0.21) 3,672 (7.83)
    Thoracic surgery 28,438 (0.28) 100,518 (1.50) 34,694 (6.94) 11,248 (5.34) 2,892 (1.54) 48,875 (8.85) 261 (0.35) 33,537 (1.81) 209 (0.06) 122 (0.26)
    Plastic surgery 8,598 (0.08) 110,218 (1.64) 1,916 (0.38) 8,022 (3.81) 1,337 (0.71) 14,533 (2.63) 420 (0.56) 4,498 (0.24) 98 (0.03) 56 (0.12)
    Anesthesiology 1,038 (0.01) 835 (0.01) 10 (<0.01) 8 (<0.01) 1 (<0.01) 20 (<0.01) 5 (0.01) 110 (0.01) 2 (<0.01) 0
    Obstetrics and gynecology 888,109 (8.62) 1,078,597 (16.05) 26,431 (5.29) 16,294 (7.73) 4,194 (2.24) 43,154 (7.82) 53 (0.07) 16,801 (0.90) 136 (0.04) 152 (0.32)
    Pediatrics 37,839 (0.37) 16,037 (0.24) 118 (0.02) 388 (0.18) 23 (0.01) 1,309 (0.24) 3,856 (5.18) 23,871 (1.28) 16,039 (4.99) 3,784 (8.07)
    Ophthalmology 20,154 (0.20) 22,715 (0.34) 36 (0.01) 611 (0.29) 10 (0.01) 1,317 (0.24) 14 (0.02) 3,399 (0.18) 132 (0.04) 85 (0.18)
    Otorhinolaryngology 123,136 (1.20) 396,701 (5.90) 31,590 (6.32) 17,180 (8.15) 464 (0.25) 50,489 (9.14) 148 (0.20) 46,797 (2.52) 254 (0.08) 197 (0.42)
    Dermatology 340,839 (3.31) 222,969 (3.32) 121 (0.02) 4,481 (2.13) 472 (0.25) 5,487 (0.99) 9 (0.01) 80,731 (4.35) 41,682 (12.96) 70 (0.15)
    Urology 286,191 (2.78) 215,571 (3.21) 12,449 (2.49) 45,382 (21.54) 17,938 (9.56) 22,137 (4.01) 70 (0.09) 15,361 (0.83) 1,916 (0.60) 542 (1.16)
    Radiology 89,520 (0.87) 7,732 (0.12) 1 (<0.01) 2 (<0.01) 1 (<0.01) 4 (<0.01) 300 (0.40) 1,113 (0.06) 0 4 (0.01)
    Radiation oncology 2,430 (0.02) 113 (<0.01) 0 0 0 1 (<0.01) 0 202 (0.01) 8 (<0.01) 1 (<0.01)
    Pathology 391 (<0.01) 15 (<0.01) 0 0 0 3 (<0.01) 0 3,249 (0.17) 19 (0.01) 4 (0.01)
    Laboratory medicine 338 (<0.01) 46 (<0.01) 0 0 0 0 24 (0.03) 921 (0.05) 0 1 (<0.01)
    Tuberculosis 233 (<0.01) 20 (<0.01) 0 0 0 0 6 (0.01) 122 (0.01) 0 0
    Rehabilitation medicine 8,784 (0.09) 4,392 (0.07) 37 (0.01) 181 (0.09) 30 (0.02) 385 (0.07) 104 (0.14) 2,131 (0.11) 500 (0.16) 135 (0.29)
    Nuclear medicine 118 (<0.01) 15 (<0.01) 0 0 1 (<0.01) 0 0 82 (<0.01) 0 0
    Family medicine 146,907 (1.43) 49,855 (0.74) 31 (0.01) 17 (0.01) 240 (0.13) 62 (0.01) 23 (0.03) 26,784 (1.44) 263 (0.08) 10 (0.02)
    Emergency medicine 15,072 (0.15) 6,035 (0.09) 166 (0.03) 190 (0.09) 41 (0.02) 276 (0.05) 97 (0.13) 5,778 (0.31) 1,381 (0.43) 309 (0.66)
    Occupational and environmental medicine 1,876 (0.02) 98 (<0.01) 0 0 0 0 1 (<0.01) 63 (<0.01) 0 0
    Preventive medicine 1,394 (0.01) 4,229 (0.06) 0 0 2 (<0.01) 0 0 3 (<0.01) 0 0
    Dental department 25,596 (0.25) 60,112 (0.89) 1,293 (0.26) 622 (0.30) 6 (<0.01) 2,799 (0.51) 2,347 (3.15) 2,624 (0.14) 1,503 (0.47) 1 (<0.01)
    Etc. 30 (<0.01) 15 (<0.01) 0 0 0 0 0 0 0 0
    Summary 10,300,893 (100) 6,718,397 (100) 500,012 (100) 210,693 (100) 187,545 (100) 552,102 (100) 74,406 (100) 1,857,684 (100) 321,632 (100) 46,900 (100)
    Requesting department ENZYME IHC CERVIX BFC AC CB HER2 MSI OUTSIDE Summary
    General 0 5 (<0.01) 363 (0.03) 275 (0.01) 846 (0.06) 13 (<0.01) 1 (0.01) 0 0 5,461 (0.02)
    Internal medicine 2,324 (26.93) 897,900 (27.95) 36,501 (3.08) 1,259,857 (48.78) 622,477 (46.63) 369,897 (68.70) 2,622 (22.91) 3,317 (5.76) 108,745 (29.90) 13,917,799 (46.29)
    Neurology 2,312 (26.79) 5,100 (0.16) 1,412 (0.12) 53,245 (2.06) 2,423 (0.18) 1,852 (0.34) 5 (0.04) 8 (0.01) 148 (0.04) 115,882 (0.39)
    Psychiatry 8 (0.09) 391 (0.01) 666 (0.06) 2,330 (0.09) 435 (0.03) 153 (0.03) 1 (0.01) 2 (<0.01) 24 (0.01) 14,374 (0.05)
    General surgery 139 (1.61) 1,413,101 (43.99) 6,204 (0.52) 104,518 (4.05) 489,190 (36.65) 49,603 (9.21) 8,311 (72.62) 53,777 (93.41) 177,028 (48.67) 6,334,913 (21.07)
    Orthopedic surgery 321 (3.72) 34,131 (1.06) 3,285 (0.28) 35,414 (1.37) 12,788 (0.96) 3,055 (0.57) 13 (0.11) 7 (0.01) 3,004 (0.83) 742,636 (2.47)
    Neurosurgery 186 (2.16) 95,260 (2.97) 1,915 (0.16) 35,088 (1.36) 3,349 (0.25) 2,957 (0.55) 23 (0.20) 8 (0.01) 825 (0.23) 446,936 (1.49)
    Thoracic surgery 6 (0.07) 91,268 (2.84) 314 (0.03) 42,808 (1.66) 3,034 (0.23) 13,872 (2.58) 30 (0.26) 92 (0.16) 7,707 (2.12) 419,925 (1.40)
    Plastic surgery 91 (1.05) 24,684 (0.77) 107 (0.01) 991 (0.04) 482 (0.04) 388 (0.07) 130 (1.14) 2 (<0.01) 1,254 (0.34) 177,825 (0.59)
    Anesthesiology 0 58 (<0.01) 70 (0.01) 371 (0.01) 135 (0.01) 31 (0.01) 0 0 5 (<0.01) 2,699 (0.01)
    Obstetrics and gynecology 17 (0.20) 152,242 (4.74) 1,099,372 (92.63) 56,916 (2.20) 28,236 (2.12) 14,401 (2.67) 21 (0.18) 203 (0.35) 19,467 (5.35) 3,444,796 (11.46)
    Pediatrics 2,489 (28.84) 31,051 (0.97) 116 (0.01) 38,929 (1.51) 1,821 (0.14) 1,494 (0.28) 0 4 (0.01) 1,258 (0.35) 180,426 (0.60)
    Ophthalmology 63 (0.73) 10,629 (0.33) 59 (<0.01) 1,608 (0.06) 848 (0.06) 364 (0.07) 1 (0.01) 0 384 (0.11) 62,429 (0.21)
    Otorhinolaryngology 4 (0.05) 125,340 (3.90) 460 (0.04) 9,871 (0.38) 83,493 (6.25) 27,339 (5.08) 1 (0.01) 7 (0.01) 21,799 (5.99) 935,270 (3.11)
    Dermatology 197 (2.28) 77,791 (2.42) 308 (0.03) 4,179 (0.16) 3,150 (0.24) 219 (0.04) 7 (0.06) 0 4,957 (1.36) 787,669 (2.62)
    Urology 9 (0.10) 193,693 (6.03) 26,181 (2.21) 876,070 (33.92) 31,351 (2.35) 11,392 (2.12) 4 (0.03) 24 (0.04) 13,370 (3.68) 1,769,651 (5.89)
    Radiology 2 (0.02) 33,526 (1.04) 298 (0.03) 1,356 (0.05) 31,699 (2.37) 23,850 (4.43) 254 (2.22) 1 (<0.01) 856 (0.24) 190,519 (0.63)
    Radiation oncology 0 915 (0.03) 3,773 (0.32) 100 (<0.01) 155 (0.01) 256 (0.05) 1 (0.01) 9 (0.02) 1,367 (0.38) 9,331 (0.03)
    Pathology 1 (0.01) 81 (<0.01) 1 (<0.01) 206 (0.01) 3,255 (0.24) 3,488 (0.65) 1 (0.01) 0 10 (<0.01) 10,724 (0.04)
    Laboratory medicine 0 7,006 (0.22) 112 (0.01) 22 (<0.01) 5 (<0.01) 2 (<0.01) 0 0 3 (<0.01) 8,480 (0.03)
    Tuberculosis 0 75 (<0.01) 10 (<0.01) 1,276 (0.05) 43 (<0.01) 87 (0.02) 0 0 61 (0.02) 1,933 (0.01)
    Rehabilitation medicine 392 (4.54) 1,884 (0.06) 648 (0.05) 6,636 (0.26) 606 (0.05) 940 (0.17) 10 (0.09) 8 (0.01) 65 (0.02) 27,868 (0.09)
    Nuclear medicine 0 62 (<0.01) 7 (<0.01) 44 (<0.01) 2,514 (0.19) 682 (0.13) 0 0 58 (0.02) 3,583 (0.01)
    Family medicine 5 (0.06) 3,524 (0.11) 2,536 (0.21) 16,582 (0.64) 11,341 (0.85) 4,132 (0.77) 1 (0.01) 5 (0.01) 398 (0.11) 262,716 (0.87)
    Emergency medicine 64 (0.74) 3,939 (0.12) 2,156 (0.18) 31,115 (1.20) 514 (0.04) 7,460 (1.39) 8 (0.07) 95 (0.17) 293 (0.08) 74,989 (0.25)
    Occupational and environmental medicine 0 18 (<0.01) 1 (<0.01) 159 (0.01) 81 (0.01) 2 (<0.01) 0 0 1 (<0.01) 2,300 (0.01)
    Preventive medicine 0 5 (<0.01) 2 (<0.01) 24 (<0.01) 188 (0.01) 0 0 0 1 (<0.01) 5,848 (0.02)
    Dental department 1 (0.01) 8,537 (0.27) 15 (<0.01) 2,875 (0.11) 372 (0.03) 516 (0.10) 0 0 648 (0.18) 109,867 (0.37)
    Etc. 0 0 1 (<0.01) 15 (<0.01) 5 (<0.01) 0 0 0 0 66 (<0.01)
    Summary 8,631 (100) 3,212,216 (100) 1,186,893 (100) 2,582,880 (100) 1,334,836 (100) 538,445 (100) 11,445 (100) 57,569 (100) 363,736 (100) 30,066,915 (100)
    Pathologic examination Tertiary hospital General hospital Hospital Convalescent hospital Clinic Dental hospital Dental clinic Public health center Public health center and county hospital Oriental hospital Summary
    Biopsy 2,354,632 (22.86) 2,617,426 (25.41) 1,387,062 (13.47) 13,460 (0.13) 3,910,624 (37.96) 13,285 (0.13) 898 (0.01) 0 2,767 (0.03) 739 (0.01) 10,300,893 (100)
    Non-maligGro 1,727,593 (25.71) 2,362,797 (35.17) 1,161,784 (17.29) 3,929 (0.06) 1,440,209 (21.44) 18,397 (0.27) 384 (0.01) 0 2,197 (0.03) 1,107 (0.02) 6,718,397 (100)
    MaligGro LND 332,395 (66.48) 149,342 (29.87) 13,548 (2.71) 2 (<0.01) 4,032 (0.81) 693 (0.14) 0 0 0 0 500,012 (100)
    MaligGro LNDX 151,392 (71.85) 56,436 (26.79) 1,999 (0.95) 16 (0.01) 567 (0.27) 282 (0.13) 0 0 1 (<0.01) 0 210,693 (100)
    MAPPING 132,776 (70.80) 52,851 (28.18) 1,705 (0.91) 7 (<0.01) 205 (0.11) 1 (<0.01) 0 0 0 0 187,545 (100)
    FS 388,171 (70.31) 158,797 (28.76) 3,730 (0.68) 21 (<0.01) 104 (0.02) 1,279 (0.23) 0 0 0 0 552,102 (100)
    BONE 35,926 (48.28) 27,499 (36.96) 9,264 (12.45) 5 (0.01) 333 (0.45) 1,378 (1.85) 1 (<0.01) 0 0 0 74,406 (100)
    SPECIAL 817,633 (44.01) 756,183 (40.71) 57,218 (3.08) 778 (0.04) 224,562 (12.09) 1,301 (0.07) 0 0 1 (<0.01) 8 (<0.01) 1,857,684 (100)
    IF 226,147 (70.31) 91,857 (28.56) 519 (0.16) 503 (0.16) 1,450 (0.45) 1,156 (0.36) 0 0 0 0 321,632 (100)
    EM 35,284 (75.23) 11,411 (24.33) 61 (0.13) 0 144 (0.31) 0 0 0 0 0 46,900 (100)
    ENZYME 7,524 (87.17) 1,093 (12.66) 9 (0.10) 0 5 (0.06) 0 0 0 0 0 8,631 (100)
    IHC 2,205,781 (68.67) 966,307 (30.08) 25,241 (0.79) 351 (0.01) 9,041 (0.28) 5,481 (0.17) 0 0 12 (<0.01) 2 (<0.01) 3,212,216 (100)
    CERVIX 490,880 (41.36) 449,685 (37.89) 70,512 (5.94) 592 (0.05) 174,700 (14.72) 0 0 3 (<0.01) 503 (0.04) 18 (<0.01) 1,186,893 (100)
    BFC 1,201,031 (46.50) 1,053,678 (40.79) 162,061 (6.27) 2,248 (0.09) 161,414 (6.25) 2,319 (0.09) 0 0 106 (<0.01) 23 (<0.01) 2,582,880 (100)
    AC 219,121 (16.42) 335,929 (25.17) 152,361 (11.41) 645 (0.05) 626,573 (46.94) 145 (0.01) 1 (<0.01) 0 32 (<0.01) 29 (<0.01) 1,334,836 (100)
    CB 293,874 (54.58) 196,885 (36.57) 20,101 (3.73) 124 (0.02) 27,092 (5.03) 369 (0.07) 0 0 0 0 538,445 (100)
    HER2 8,605 (75.19) 2,747 (24.00) 86 (0.75) 6 (0.05) 1 (0.01) 0 0 0 0 0 11,445 (100)
    MSI 49,100 (85.29) 8,318 (14.45) 151 (0.26) 0 0 0 0 0 0 0 57,569 (100)
    OUTSIDE 276,885 (76.12) 75,385 (20.73) 1,391 (0.38) 47 (0.01) 9,667 (2.66) 360 (0.10) 0 0 0 1 (<0.01) 363,736 (100)
    Summary 10,954,750 (36.43) 9,374,626 (31.18) 3,068,803 (10.21) 22,734 (0.08) 6,590,723 (21.92) 46,446 (0.15) 1,284 (<0.01) 3 (<0.01) 5,619 (0.02) 1,927 (0.01) 30,066,915 (100)
    Administrative district Biopsy Non-maligGro MaligGro LND MaligGro LNDX MAPPING FS BONE SPECIAL IF EM
    Etc. 0 21 (<0.01) 0 0 0 0 0 0 0 0
    Seoul 3,569,090 (30.24) 2,487,048 (32.18) 267,423 (46.34) 113,181 (46.84) 109,012 (50.46) 317,546 (49.92) 22,231 (27.33) 830,214 (37.57) 169,672 (46.92) 26,715 (51.53)
    Busan 1,007,783 (8.54) 718,747 (9.30) 57,598 (9.98) 26,132 (10.81) 18,263 (8.45) 61,611 (9.69) 9,156 (11.25) 101,122 (4.58) 39,230 (10.85) 5,599 (10.80)
    Incheon 701,281 (5.94) 457,064 (5.91) 42,029 (7.28) 20,095 (8.32) 12,743 (5.90) 41,553 (6.53) 5,388 (6.62) 158,767 (7.18) 18,329 (5.07) 1,915 (3.69)
    Daegu 914,814 (7.75) 505,092 (6.54) 43,935 (7.61) 13,662 (5.65) 9,264 (4.29) 35,356 (5.56) 10,090 (12.40) 161,162 (7.29) 22,793 (6.30) 3,466 (6.68)
    Gwangju 419,909 (3.56) 314,418 (4.07) 9,260 (1.60) 2,575 (1.07) 1,216 (0.56) 7,133 (1.12) 635 (0.78) 31,555 (1.43) 6,476 (1.79) 1,167 (2.25)
    Daejeon 435,340 (3.69) 309,986 (4.01) 19,421 (3.37) 3,075 (1.27) 3,934 (1.82) 13,359 (2.10) 6,968 (8.56) 66,516 (3.01) 12,276 (3.39) 1,732 (3.34)
    Ulsan 250,163 (2.12) 168,514 (2.18) 8,207 (1.42) 4,827 (2.00) 138 (0.06) 8,178 (1.29) 2,136 (2.63) 41,843 (1.89) 6,577 (1.82) 698 (1.35)
    Gyeonggi-do 1,978,367 (16.76) 1,287,772 (16.66) 67,488 (11.70) 28,882 (11.95) 37,470 (17.35) 78,222 (12.30) 11,599 (14.26) 436,544 (19.75) 49,950 (13.81) 5,760 (11.11)
    Gangwon-do 228,857 (1.94) 150,249 (1.94) 6,447 (1.12) 3,586 (1.48) 4,503 (2.08) 10,730 (1.69) 3,151 (3.87) 67,670 (3.06) 7,882 (2.18) 758 (1.46)
    Chungcheongbuk-do 250,413 (2.12) 171,847 (2.22) 5,083 (0.88) 1,591 (0.66) 590 (0.27) 5,706 (0.90) 1,927 (2.37) 61,513 (2.78) 2,266 (0.63) 385 (0.74)
    Chungcheongnam-do 313,423 (2.66) 155,444 (2.01) 5,393 (0.93) 2,529 (1.05) 3,700 (1.71) 6,237 (0.98) 177 (0.22) 41,352 (1.87) 6,644 (1.84) 727 (1.40)
    Jeollabuk-do 349,185 (2.96) 192,196 (2.49) 11,396 (1.97) 7,030 (2.91) 4,207 (1.95) 14,340 (2.25) 3,226 (3.97) 20,504 (0.93) 3,829 (1.06) 458 (0.88)
    Jeollanam-do 295,622 (2.50) 177,955 (2.30) 16,774 (2.91) 7,613 (3.15) 30 (0.01) 11,400 (1.79) 245 (0.30) 35,185 (1.59) 1,056 (0.29) 200 (0.39)
    Gyeongsangbuk-do 451,285 (3.82) 220,085 (2.85) 1,936 (0.34) 816 (0.34) 1,159 (0.54) 1,852 (0.29) 1,028 (1.26) 44,136 (2.00) 2,140 (0.59) 270 (0.52)
    Gyeongsangnam-do 532,322 (4.51) 352,022 (4.55) 12,136 (2.10) 5,078 (2.10) 8,698 (4.03) 19,881 (3.13) 2,205 (2.71) 78,121 (3.54) 9,437 (2.61) 1,572 (3.03)
    Jeju 100,466 (0.85) 57,359 (0.74) 2,538 (0.44) 961 (0.40) 1,094 (0.51) 3,023 (0.48) 1,194 (1.47) 33,540 (1.52) 3,070 (0.85) 426 (0.82)
    Sejong-si 4,372 (0.04) 3,023 (0.04) 0 0 0 0 0 104 (<0.01) 0 0
    Summary 11,802,692 (100) 7,728,842 (100) 577,064 (100) 241,633 (100) 216,021 (100) 636,127 (100) 81,356 (100) 2,209,848 (100) 361,627 (100) 51,848 (100)
    Administrative district ENZYME IHC CERVIX BFC AC CB HER2 MSI OUTSIDE Summary
    Etc. 0 0 0 0 0 0 0 0 0 21 (<0.01)
    Seoul 6,622 (71.09) 1,767,200 (46.85) 543,513 (40.40) 1,146,492 (39.19) 338,246 (22.66) 273,523 (44.02) 6,944 (52.83) 36,679 (55.68) 261,862 (61.69) 12,293,213 (35.55)
    Busan 521 (5.59) 309,799 (8.21) 106,119 (7.89) 307,125 (10.50) 184,239 (12.34) 42,686 (6.87) 898 (6.83) 6,723 (10.21) 24,460 (5.76) 3,027,811 (8.76)
    Incheon 144 (1.55) 234,731 (6.22) 86,153 (6.40) 235,529 (8.05) 92,453 (6.19) 38,392 (6.18) 1,297 (9.87) 4,462 (6.77) 19,867 (4.68) 2,172,192 (6.28)
    Daegu 501 (5.38) 402,725 (10.68) 88,991 (6.62) 131,159 (4.48) 150,027 (10.05) 64,550 (10.39) 815 (6.20) 3,096 (4.70) 22,940 (5.40) 2,584,438 (7.47)
    Gwangju 136 (1.46) 36,164 (0.96) 38,359 (2.85) 74,981 (2.56) 133,266 (8.93) 4,443 (0.72) 27 (0.21) 0 1,441 (0.34) 1,083,161 (3.13)
    Daejeon 53 (0.57) 71,899 (1.91) 40,038 (2.98) 83,455 (2.85) 45,632 (3.06) 7,065 (1.14) 194 (1.48) 36 (0.05) 9,240 (2.18) 1,130,219 (3.27)
    Ulsan 4 (0.04) 46,112 (1.22) 18,427 (1.37) 53,310 (1.82) 30,219 (2.02) 8,665 (1.39) 153 (1.16) 2 (<0.01) 3,367 (0.79) 651,540 (1.88)
    Gyeonggi-do 849 (9.11) 569,103 (15.09) 219,328 (16.30) 374,113 (12.79) 221,132 (14.81) 92,707 (14.92) 1,820 (13.85) 10,526 (15.98) 58,704 (13.83) 5,530,336 (15.99)
    Gangwon-do 24 (0.26) 63,272 (1.68) 35,913 (2.67) 69,897 (2.39) 15,218 (1.02) 17,189 (2.77) 208 (1.58) 624 (0.95) 1,517 (0.36) 687,695 (1.99)
    Chungcheongbuk-do 0 13,816 (0.37) 11,057 (0.82) 45,783 (1.56) 30,046 (2.01) 8,844 (1.42) 55 (0.42) 371 (0.56) 2,802 (0.66) 614,095 (1.78)
    Chungcheongnam-do 6 (0.06) 26,956 (0.71) 29,260 (2.18) 56,711 (1.94) 23,501 (1.57) 17,295 (2.78) 167 (1.27) 0 2,420 (0.57) 691,942 (2.00)
    Jeollabuk-do 8 (0.09) 71,973 (1.91) 28,958 (2.15) 93,002 (3.18) 54,035 (3.62) 2,377 (0.38) 150 (1.14) 259 (0.39) 3,424 (0.81) 860,557 (2.49)
    Jeollanam-do 3 (0.03) 55,684 (1.48) 27,585 (2.05) 55,997 (1.91) 68,206 (4.57) 5,211 (0.84) 285 (2.17) 798 (1.21) 6,128 (1.44) 765,977 (2.22)
    Gyeongsangbuk-do 10 (0.11) 8,784 (0.23) 26,061 (1.94) 58,344 (1.99) 41,342 (2.77) 6,361 (1.02) 7 (0.05) 1 (<0.01) 330 (0.08) 865,947 (2.50)
    Gyeongsangnam-do 339 (3.64) 70,854 (1.88) 30,645 (2.28) 109,302 (3.74) 54,687 (3.66) 29,855 (4.80) 92 (0.70) 2,266 (3.44) 5,066 (1.19) 1,324,578 (3.83)
    Jeju 95 (1.02) 22,901 (0.61) 14,340 (1.07) 30,246 (1.03) 10,421 (0.70) 2,217 (0.36) 33 (0.25) 36 (0.05) 933 (0.22) 284,893 (0.82)
    Sejong-si 0 5 (<0.01) 484 (0.04) 129 (<0.01) 331 (0.02) 12 (<0.01) 0 0 2 (<0.01) 8,462 (0.02)
    Summary 9,315 (100) 3,771,978 (100) 1,345,231 (100) 2,925,575 (100) 1,493,001 (100) 621,392 (100) 13,145 (100) 65,879 (100) 424,503 (100) 34,577,077 (100)
    Pathologic examination Performed in their own hospitals Performed using outside services Convalescent hospital Etc. Summary
    Biopsy 4,484,330 (43.53) 5,784,009 (56.15) 28,542 (0.28) 4,012 (0.04) 10,300,893 (100)
    Non-maligGro 3,621,714 (53.91) 3,034,515 (45.17) 61,635 (0.92) 533 (0.01) 6,718,397 (100)
    MaligGro LND 475,825 (95.16) 20,673 (4.13) 3,512 (0.70) 2 (<0.01) 500,012 (100)
    MaligGro LNDX 206,618 (98.07) 3,252 (1.54) 821 (0.39) 2 (<0.01) 210,693 (100)
    MAPPING 185,267 (98.79) 1,123 (0.60) 1,152 (0.61) 3 (<0.01) 187,545 (100)
    FS 545,200 (98.75) 4,089 (0.74) 2,806 (0.51) 7 (<0.01) 552,102 (100)
    BONE 58,330 (78.39) 13,576 (18.25) 2,496 (3.35) 4 (0.01) 74,406 (100)
    SPECIAL 1,487,782 (80.09) 363,521 (19.57) 5,793 (0.31) 588 (0.03) 1,857,684 (100)
    IF 259,628 (80.72) 58,684 (18.25) 3,317 (1.03) 3 (<0.01) 321,632 (100)
    EM 31,593 (67.36) 15,175 (32.36) 132 (0.28) 0 46,900 (100)
    ENZYME 7,779 (90.13) 787 (9.12) 65 (0.75) 0 8,631 (100)
    IHC 3,129,765 (97.43) 62,839 (1.96) 19,503 (0.61) 109 (<0.01) 3,212,216 (100)
    CERVIX 901,312 (75.94) 278,397 (23.46) 1,057 (0.09) 6,127 (0.52) 1,186,893 (100)
    BFC 2,068,613 (80.09) 490,820 (19.00) 22,888 (0.89) 559 (0.02) 2,582,880 (100)
    AC 458,090 (34.32) 855,980 (64.13) 489 (0.04) 20,277 (1.52) 1,334,836 (100)
    CB 505,034 (93.79) 29,688 (5.51) 3,073 (0.57) 650 (0.12) 538,445 (100)
    HER2 9,856 (86.12) 1,587 (13.87) 2 (0.02) 0 11,445 (100)
    MSI 35,244 (61.22) 22,325 (38.78) 0 0 57,569 (100)
    OUTSIDE 356,892 (98.12) 6,640 (1.83) 165 (0.05) 39 (0.01) 363,736 (100)
    Summary 18,828,872 (62.62) 11,047,680 (36.74) 157,448 (0.52) 32,915 (0.11) 30,066,915 (100)
    Table 1. Pathologic examination codes using in this study

    Non-maligGro, resected specimen requiring gross sectioning; NPB, number of paraffin blocks; MaligGro, resected specimen for malignant tumor requiring gross sectioning; LND, with lymph node dissection; LNDX, without lymph node dissection; MAPPING, histologic mapping of tumor; FS, emergency histopathologic examination during surgery; BONE, histopathologic examination for bone; SPECIAL, special stain examinations; IF, tissue immunofluorescent microscopic examination; EM, tissue electron microscopy; ENZYME, enzyme histochemistry; IHC, immunohisto(cyto)chemistry; HR, examination of hormone receptor in tissue; CERVIX, cervicovaginal cytopathology; L-, liquid based; BFC, body fluid cytopathology; AC, aspiration cytopathology; CB, cell block; HER2 (FISH), HER2 gene fluorescence in situ hybridization; HER2 (SISH), HER2 gene silver in situ hybridization; MSI, microsatellite instability; OUTSIDE, outside slide interpretation.

    Table 2. Annual pathologic examination status and trend

    Values are presented as number (%).

    Non-maligGro, resected specimen requiring gross sectioning; MaligGro, resected specimen for malignant tumor requiring gross sectioning; LND, with lymph node dissection; LNDX, without lymph node dissection; MAPPING, histologic mapping of tumor; FS, emergency histopathologic examination during surgery; BONE, histopathologic examination for bone; SPECIAL, special stain examinations; IF, tissue immunofluorescent microscopic examination; EM, tissue electron microscopy; ENZYME, enzyme histochemistry; IHC, immunohisto(cyto)chemistry; CERVIX, cervicovaginal cytopathology; BFC, body fluid cytopathology; AC, aspiration cytopathology; CB, cell block; HER2, HER2 gene fluorescence in situ hybridization and HER2 gene silver in situ hybridization; MSI, microsatellite instability; OUTSIDE, outside slide interpretation.

    Table 3. Pathologic examination numbers according to requesting department in 2011–2015: part I (sort based on department codes)

    Values are presented as number (%).

    Non-maligGro, resected specimen requiring gross sectioning; MaligGro, resected specimen for malignant tumor requiring gross sectioning; LND, with lymph node dissection; LNDX, without lymph node dissection; MAPPING, histologic mapping of tumor; FS, emergency histopathologic examination during surgery; BONE, histopathologic examination for bone; SPECIAL, special stain examinations; IF, tissue immunofluorescent microscopic examination; EM, tissue electron microscopy

    Table 4. Pathologic examination numbers according to requesting department in 2011–2015: part II (sort based on department codes)

    Values are presented as number (%).

    ENZYME, enzyme histochemistry; IHC, immunohisto(cyto)chemistry; CERVIX, cervicovaginal cytopathology; BFC, body fluid cytopathology; AC, aspiration cytopathology; CB, cell block; HER2, HER2 gene fluorescence in situ hybridization and HER2 gene silver in situ hybridization; MSI, microsatellite instability; OUTSIDE, outside slide interpretation.

    Table 5. Pathologic examination status according to types of medical institutions in 2011–2015

    Values are presented as number (%).

    Non-maligGro, resected specimen requiring gross sectioning; MaligGro, resected specimen for malignant tumor requiring gross sectioning; LND, with lymph node dissection; LNDX, without lymph node dissection; MAPPING, histologic mapping of tumor; FS, emergency histopathologic examination during surgery; BONE, histopathologic examination for bone; SPECIAL, special stain examinations; IF, tissue immunofluorescent microscopic examination; EM, tissue electron microscopy; ENZYME, enzyme histochemistry; IHC, immunohisto(cyto)chemistry; CERVIX, cervicovaginal cytopathology; BFC, body fluid cytopathology; AC, aspiration cytopathology; CB, cell block; HER2, HER2 gene fluorescence in situ hybridization and HER2 gene silver in situ hybridization; MSI, microsatellite instability; OUTSIDE, outside slide interpretation.

    Table 6. Pathologic examination status according to administrative districts in 2011–2015: part I (sort based on administrative districts codes)

    Values are presented as number (%).

    Non-maligGro, resected specimen requiring gross sectioning; MaligGro, resected specimen for malignant tumor requiring gross sectioning; LND, with lymph node dissection; LNDX, without lymph node dissection; MAPPING, histologic mapping of tumor; FS, emergency histopathologic examination during surgery; BONE, histopathologic examination for bone; SPECIAL, special stain examinations; IF, tissue immunofluorescent microscopic examination; EM, tissue electron microscopy.

    Table 7. Pathologic examination status according to administrative districts in 2011–2015: part II (sort based on administrative districts codes)

    Values are presented as number (%).

    ENZYME, enzyme histochemistry; IHC, immunohisto(cyto)chemistry; CERVIX, cervicovaginal cytopathology; BFC, body fluid cytopathology; AC, aspiration cytopathology; CB, cell block; HER2, HER2 gene fluorescence in situ hybridization and HER2 gene silver in situ hybridization; MSI, microsatellite instability; OUTSIDE, outside slide interpretation.

    Table 8. Summary of the types of institutions where pathologic examinations were done during 2011.2015

    Values are presented as number (%).

    Non-maligGro, resected specimen requiring gross sectioning; MaligGro, resected specimen for malignant tumor requiring gross sectioning; LND, with lymph node dissection; LNDX, without lymph node dissection; MAPPING, histologic mapping of tumor; FS, emergency histopathologic examination during surgery; BONE, histopathologic examination for bone; SPECIAL, special stain examinations; IF, tissue immunofluorescent microscopic examination; EM, tissue electron microscopy; ENZYME, enzyme histochemistry; IHC, immunohisto(cyto)chemistry; CERVIX, cervicovaginal cytopathology; BFC, body fluid cytopathology; AC, aspiration cytopathology; CB, cell block; HER2, HER2 gene fluorescence in situ hybridization and HER2 gene silver in situ hybridization; MSI, microsatellite instability; OUTSIDE, outside slide interpretation.


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