Danish Prostate Cancer Registry – methodology and early results from a novel national database

Abstract

BackgroundSystematized Nomenclature of Medicine (SNOMED) codes are computer-processable medical terms used to describe histopathological evaluations. SNOMED codes are not readily usable for analysis. We invented an algorithm that converts prostate SNOMED codes into an analyzable format. We present the methodology and early results from a new national Danish prostate database containing clinical data from all males who had evaluation of prostate tissue from 1995 to 2011.Materials and methodsSNOMED codes were retrieved from the Danish Pathology Register. A total of 26,295 combinations of SNOMED codes were identified. A computer algorithm was developed to transcode SNOMED codes into an analyzable format including procedure (eg, biopsy, transurethral resection, etc), diagnosis, and date of diagnosis. For validation, ~55,000 pathological reports were manually reviewed. Prostate-specific antigen, vital status, causes of death, and tumor-node-metastasis classification were integrated from national registries.ResultsOf the 161,525 specimens from 113,801 males identified, 83,379 (51.6%) were sets of prostate biopsies, 56,118 (34.7%) were transurethral/transvesical resections of the prostate (TUR-Ps), and the remaining 22,028 (13.6%) specimens were derived from radical prostatectomies, bladder interventions, etc. A total of 48,078 (42.2%) males had histopathologically verified prostate cancer, and of these, 78.8% and 16.8% were diagnosed on prostate biopsies and TUR-Ps, respectively.Future perspectivesA validated algorithm was successfully developed to convert complex prostate SNOMED codes into clinical useful data. A unique database, including males with both normal and cancerous histopathological data, was created to form the most comprehensive national prostate database to date. Potentially, our algorithm can be used for conversion of other SNOMED data and is available upon request.

Quality indicators of clinical cancer care for prostate cancer: a population-based study in southern Switzerland

“…In our analysis the transurethral prostatic resection (TUR-P) is not considered as needle-biopsy. Our result is in line with other population-based studies: 84.7 and 78.8% of PC were diagnosed through a transrectal ultrasound guided biopsy, in the regions of South Australia and Victoria and in Denmark respectively [ 23 , 34 ]. QI2.…”

Trends in incidence and 5‐year mortality in men with newly diagnosed, metastatic prostate cancer—A population‐based analysis of 2 national cohorts

“…In the DaPCaR, tumors were classified as localized, regionally advanced, or distant metastatic until 2004. Since then the TNM (International Classification of Diseases, 10th Edition) classification system has been used as previously described . All men were stratified in 5‐year to 7‐year intervals according to the year of diagnosis.…”

“…From the Danish Prostate Cancer Registry (DaPCaR), all Danish men diagnosed with PCa in the period from 1995 to 2011 were identified. Patients were followed from 1995 until death or April 28, 2015 . To calculate incidence rates, age‐specific population figures were retrieved from Statistics Denmark .…”

“…Patients were followed from 1995 until death or April 28, 2015. 20 To calculate incidence rates, age-specific population figures were retrieved from Statistics Denmark. 18 Age, Gleason score (GS), PSA level (DaPCaR only), and tumor stage at diagnosis were retrieved for all patients diagnosed with de novo metastatic disease.…”

“…Since then the TNM (International Classification of Diseases, 10th Edition) classification system has been used as previously described. 20 All men were stratified in 5-year to 7-year intervals according to the year of diagnosis. Trends in the age-standardized (World Health Organization world population) incidence rates of de novo metastatic and otherstage PCa from both cohorts were analyzed.…”