Additional details about our data sources
While RCRD is compiled mainly from COSD records, the speed of production means that the range of data items is limited and several standard data items in the complete National Cancer Registration Dataset (NCRD) are unavailable. We therefore also report data completeness for a few select items from the COSD that are not reported in the RCRD, but that will be required to develop and report key performance indicators. It is also worth noting that RCRD does not have complete coverage of all patients diagnosed with prostate cancer in England during the reporting period. To access more information about the RCRD click here.
RCRD and COSD are received by NATCAN quarterly. The RCRD received contained patient data submitted to NDRS by English NHS trusts for people diagnosed between 1st January 2018 and 31st October 2024. For the data quality metrics that use RCRD, we have included the three most recent years of data in this quarterly report except we have not included October 2024 so that we could align with the quarters by calendar year (Q1 = Jan-Mar; Q2 = Apr-Jun; Q3 = Jul-Sep; Q4 = Oct-Dec).
Some of the COSD data items received (e.g. lesion size and TNM) contained patient data submitted to NDRS by English NHS trusts for people diagnosed between 1st January 2018 and 31st August 2023. For the data quality metrics that use these COSD data items, we have included the latest 21 months of data in this quarterly report except we have not included July and August 2023 so that we could align quarters by calendar year.
For the performance indicator, the NPCA utilised data from RCRD and linked datasets. HES APC dataset was used to identify prostate cancer surgery. There is also currently a lag in receipt of required Hospital Episodes Statistics Admitted Patient Care (HES APC) data and Systemic Anti-Cancer Therapy (SACT) data compared the main cancer registration dataset (RCRD).
Why do we report data completeness?
We report on data completeness as this aspect of data quality underpins what we can reliably and robustly report as an audit. We encourage all provider teams to review their data completeness and make improvements as this will increase the number of people we can include in analyses and increase the range of analyses we can conduct.
How did we select our performance indicator?
The performance indicator we report quarterly is “Emergency readmission within 90 days of radical prostate cancer surgery”. This was selected based on methodological development work conducted by the NPCA which deemed RCRD a suitable data source for this indicator. The other NPCA State of the Nation report indicators are currently challenging to report quarterly due to the length of follow-up required (2 years) or due to current limitations of the RCRD such as lag in availability of TNM and Gleason score which are used for cohort definition.
Going forward, the team will continue development work, in consultation with stakeholders, to determine which performance indicators are appropriate for quarterly reporting using the RCRD.
How have we chosen these specific data items to focus on for our data quality metrics?
The specific data items we report the completeness of were chosen in collaboration with the audit’s clinical and methodological experts.
Ethnicity was chosen as we would like to thoroughly explore inequalities in cancer care which is a priority for NHS England. To enable this, it is important that every patient has ethnicity accurately recorded.
Gleason score, which is a measure assigned by a pathologist to determine how aggressive an individual’s prostate cancer is when the prostate cancer tissue is examined using a microscope, was chosen as it is essential for risk stratifying patients. This allows us to compare results between providers and assess the eligibility of patients for different treatments.
Performance status was chosen as it is important across cancers for assessing the eligibility of patients for different treatments.
PSA, which is the result from a Prostate Specific Antigen test, is essential for risk stratifying patients. This allows us to compare results between providers and assess the eligibility of patients for different treatments.
TNM, which is stage of disease where “T” represents the local stage, “N” represents the presence of lymph node involvement and “M” represents the presence of metastatic disease, is essential for risk stratifying patients. In prostate cancer TNM is particularly important as knowing whether a patient is stage I-IV does not provide information regarding regional lymph node involvement as well as distant metastatic disease