Data Resource Profile: National Cancer Registration Dataset in England

Henson, Katherine E; Elliss‐Brookes, Lucy; Coupland, Victoria H.; Payne, Elsita; Vernon, Sally; Rous, Brian; Rashbass, Jem

doi:10.1093/ije/dyz076

Cited by 174 publications

(165 citation statements)

References 18 publications

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“…The NCDA represents a unique combination of information provided by GPs and other health-care professionals based on clinical insight and judgment, with high-quality information about patient and tumour characteristics from the national cancer registry in England. 17,25 Presenting symptoms of patients with cancer In addition to adjusting our findings by sociodemographic factors, we adjusted our results by cancer site. Although this adjustment did not appear to substantially alter the observed patterns of variation, the associations between symptoms and stage at diagnosis might differ in a population-based incident cohort with a different distribution of cancer sites.…”

Section: Discussionmentioning

confidence: 99%

Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study

Koo

Swann

McPhail

et al. 2020

The Lancet Oncology

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135

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Background Early diagnosis interventions such as symptom awareness campaigns increasingly form part of global cancer control strategies. However, these strategies will have little impact in improving cancer outcomes if the targeted symptoms represent advanced stage of disease. Therefore, we aimed to examine associations between common presenting symptoms of cancer and stage at diagnosis. Methods In this cross-sectional study, we analysed population-level data from the English National Cancer Diagnosis Audit 2014 for patients aged 25 years and older with one of 12 types of solid tumours (bladder, breast, colon, endometrial, laryngeal, lung, melanoma, oral or oropharyngeal, ovarian, prostate, rectal, and renal cancer). We considered 20 common presenting symptoms and examined their associations with stage at diagnosis (TNM stage IV vs stage I-III) using logistic regression. For each symptom, we estimated these associations when reported as a single presenting symptom and when reported together with other symptoms. Findings We analysed data for 7997 patients. The proportion of patients diagnosed with stage IV cancer varied substantially by presenting symptom, from 1% (95% CI 1-3; eight of 584 patients) for abnormal mole to 80% (71-87; 84 of 105 patients) for neck lump. Three of the examined symptoms (neck lump, chest pain, and back pain) were consistently associated with increased odds of stage IV cancer, whether reported alone or with other symptoms, whereas the opposite was true for abnormal mole, breast lump, postmenopausal bleeding, and rectal bleeding. For 13 of the 20 symptoms (abnormal mole, breast lump, post-menopausal bleeding, rectal bleeding, lower urinary tract symptoms, haematuria, change in bowel habit, hoarseness, fatigue, abdominal pain, lower abdominal pain, weight loss, and the "any other symptom" category), more than 50% of patients were diagnosed at stages other than stage IV; for 19 of the 20 studied symptoms (all except for neck lump), more than a third of patients were diagnosed at stages other than stage IV. Interpretation Despite specific presenting symptoms being more strongly associated with advanced stage at diagnosis than others, for most symptoms, large proportions of patients are diagnosed at stages other than stage IV. These findings provide support for early diagnosis interventions targeting common cancer symptoms, countering concerns that they might be simply expediting the detection of advanced stage disease.

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Section: Discussionmentioning

confidence: 99%

Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study

Koo

Swann

McPhail

et al. 2020

The Lancet Oncology

Self Cite

135

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“…NCRAS collects data on all cancers diagnosed in England. This includes demographic information, date of diagnosis, treatment and vital status through the Office for National Statistics 22. The survey, however, includes only patients discharged in a recent 3-month period from hospital, regardless of their date of diagnosis.…”

Section: Methodsmentioning

confidence: 99%

“…The National Cancer Registration and Analysis Service (NCRAS) collects data on all incident cancer diagnoses in England 22. Focusing on the four most common cancers in England (colorectal, lung, breast and prostate), we aimed to compare the survey responders’ demographic and tumour stage at diagnosis and their median survival time to determine the extent to which they represent the cancer registry population and to inform future surveys.…”

Section: Introductionmentioning

confidence: 99%

How representative are colorectal, lung, breast and prostate cancer patients responding to the National Cancer Patient Experience Survey (CPES) of the cancer registry population in England? A population-based case control study

et al. 2019

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ObjectiveTo assess the representativeness of National Cancer Patient Experience Survey (CPES) responders compared with the English cancer registry population in term of age, sex, socioeconomic deprivation, ethnicity, disease stage and median survival.DesignPopulation-based case-control study.SettingEngland.PopulationWe identified 103 186 colorectal, lung, breast and prostate cancer patients responding to at least one survey during 2010–2014 and randomly selected one non-responder from the cancer registry matched on cancer type and yearly quarter of diagnosis.Main outcome measureWe compared age, sex, socioeconomic deprivation, ethnicity and disease stage between the two groups using logistic regression. We also compared survival (in years) using the Mann-Whitney test.ResultsAcross all cancer types survey responders were younger, more likely to have a White ethnic background, to be resident in less deprived areas and diagnosed with earlier stage disease although they varied between cancers. Median survival for responders was also higher than for the cancer registry population (colorectal: 4.8 vs 3.2; lung: 2.0 vs 0.3; breast: 5.7 vs 5.4; and prostate: 5.7 vs 5.2 years; all p-values<0.001).ConclusionCPES responders with the four most common cancers do not necessarily represent all patients with these cancers in terms of demographic characteristics and tumour stage at diagnosis. These limitations should be considered when interpreting findings. To capture the experiences of patients currently underrepresented in CPES, different approaches may need to be taken.

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“…A cohort of 27 719 primary diagnoses of endometrial cancer (identified using International Classification of Diseases 10th revision codes as C54, including carcinoma, adenocarcinoma, adenosquamous, serous, clear cell histological types only [see Supplementary material, Table S1]) in England between 2013 and 2016 was obtained from Public Health England's national cancer registry data . This was linked to SACT (Systemic Anti‐Cancer Therapy), RTDS (Radiotherapy DataSet) and inpatient HES (Hospital Episode Statistics) data sets to obtain additional chemotherapy, radiotherapy and surgery data, respectively.…”

Section: Methodsmentioning

confidence: 99%

Geographic variation in the use of lymphadenectomy and external‐beam radiotherapy for endometrial cancer: a cross‐sectional analysis of population‐based data

White

Nordin

Fry

et al. 2019

BJOG

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Objective To quantify geographic variation in the use of lymphadenectomy and/or external-beam radiotherapy (EBRT) for endometrial cancer in England.Design Cross-sectional analysis of population-based data.Setting English cancer registry data, linked to chemotherapy, radiotherapy and hospital episodes statistics data.Population Twenty-two thousand four hundred and eighty-three women with endometrial cancer presenting without clinical or radiological evidence of distant metastatic spread, diagnosed in England from 2013 to 2016.Methods Proportions of patients receiving lymphadenectomy and/ or EBRT were compared across 19 Cancer Alliances, to identify variations in clinical practice. Two separate logistic regression models assessed the impact on variation of adjustment for tumour and patient characteristics.Main outcome measures Receipt of lymphadenectomy, receipt of EBRT.Results There was substantial variation by Cancer Alliance in the adjusted proportion of women with endometrial cancer receiving lymphadenectomy (range 5% [95% CI 4-6%] to 48% [95% CI 45-52%]) and EBRT (range 10% [95% CI 7-12%] to 31% [95% CI 28-33%]), after adjusting for variation in pathological grade, age, comorbidities, deprivation, ethnic group and (EBRT only) FIGO stage. Different approaches to clinical practice were identified; (i) one Cancer Alliance had significantly higher than average lymphadenectomy and significantly lower than average EBRT use, (ii) three had high use of both lymphadenectomy and EBRT, (iii) one had low lymphadenectomy use and high EBRT use, and (iv) three had low use of both lymphadenectomy and EBRT.Conclusions Lymphadenectomy is probably used to triage for EBRT when lymphadenectomy use is high and EBRT use is low. This is probably a result of variation in local endometrial cancer management guidelines, suggesting that UK recommendations should be clarified.Keywords carcinoma of the endometrium: diagnosis, carcinoma of the endometrium: radiation therapy, carcinoma of the endometrium: surgery, epidemiology: gynaecological cancer, gynaecological surgery: gynaecological cancer, gynaecology: endometrial sampling.Tweetable abstract There is geographic variation in England in the use of lymphadenectomy and radiotherapy to treat endometrial cancer.

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Data Resource Profile: National Cancer Registration Dataset in England

Cited by 174 publications

References 18 publications

Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study

Presenting symptoms of cancer and stage at diagnosis: evidence from a cross-sectional, population-based study

How representative are colorectal, lung, breast and prostate cancer patients responding to the National Cancer Patient Experience Survey (CPES) of the cancer registry population in England? A population-based case control study

Geographic variation in the use of lymphadenectomy and external‐beam radiotherapy for endometrial cancer: a cross‐sectional analysis of population‐based data

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