NKCA Quarterly Report January 2021 to December 2023 (published July 2024)

The purpose of the National Kidney Cancer Audit (NKCA) is to evaluate the patterns of care and outcomes for people diagnosed with kidney cancer in England and Wales, and to support services to improve the quality of care for these patients.

Patient cohort / reporting periods

This quarterly report provides an overview of the quality of key data items for 27,427 people diagnosed with kidney cancer in England between 1st January 2021 and 31st December 2023.

For this quarterly report, the National Kidney Cancer Audit (NKCA) utilised data from the Rapid Cancer Registration Dataset (RCRD) and Cancer Outcomes and Services Dataset (COSD). 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. RCRD and COSD were received by the National Cancer Audit Collaborating Centre (NATCAN) in May 2024. The RCRD received contained patient data submitted to National Disease Registration Service (NDRS) by English NHS trusts for people diagnosed between 1st January 2018 and 31st January 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 January 2024 so that we could align with the year’s natural quarters (Q1 = Jan-Mar; Q2 = Apr-Jun; Q3 = Jul-Sep; Q4 = Oct-Dec). Some of the COSD data items received contained patient data submitted to NDRS by English NHS trusts for people diagnosed between 1st January 2018 and 31st October 2022. 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 October 2022 so that we could align with the year’s natural quarters (Q1 = Jan-Mar; Q2 = Apr-Jun; Q3 = Jul-Sep; Q4 = Oct-Dec).

Why have we focused on data completeness?

This is the second quarterly report published by the NKCA team. The NKCA quarterly report will initially include data quality metrics only. 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. These future performance indicators are likely to concern the kidney cancer patient diagnostic pathway, treatments and outcomes.

We have initially focused 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. By focusing exclusively on data completeness for this report, we are aiming to shine a spotlight on areas where improvements are needed.

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NKCA Quarterly Report, January 2021 to December 2023

How have we chosen these specific data items to focus on?

The specific data items we report the completeness of were chosen in collaboration with the audit’s clinical and methodological experts.

Clinical nurse specialist was chosen as we would like to better explore the experience of people diagnosed with kidney cancer so improving the completeness of this data item is key.

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.

Lesion size was chosen as it is important in kidney cancer for assessing the eligibility of patients for different treatments.

Multidisciplinary team (MDT) first meeting date was chosen as we would like to investigate what proportion of people diagnosed with kidney cancer are discussed at an MDT before undergoing treatment.

Morphology was selected as it could allow us to explore kidney cancer subtypes.

Performance status was chosen as it is important across cancers for assessing 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 kidney 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. We are also interested in whether full T stage (T1a, T1b, etc.) is recorded as that is useful for assessing eligibility for different treatments.

How to interpret the graph

It is natural for metric values to vary from quarter to quarter. This might be due to random variation or to changes in hospital activity. The moving average smooths the changes in the sequence of values to a certain extent, and this can help to reveal longer term trends / changes in patterns of data completeness.

Last updated: 11 July 2024, 9:41am