NKCA Quarterly Report October 2020 to September 2023 - published April 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 27,187 people diagnosed with kidney cancer in England between 1st October 2020 and 30th September 2023.

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NKCA Quarterly Report, October 2020 to September 2023

For this quarterly report, the 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 will be required to develop and report key performance indicators for the NKCA. RCRD and COSD were received by the National Cancer Audit Collaborating Centre (NATCAN) in February 2024. The RCRD received contained patient data submitted to the National Disease Registration Service (NDRS) by English NHS trusts for people diagnosed between 1st January 2018 and 31st October 2023. 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 2023 so that we could align with the quarters by calendar year (Q1 = Jan-Mar; Q2 = Apr-Jun; Q3 = Jul-Sep; Q4 = Oct-Dec). The COSD received contained patient data submitted to NDRS by English NHS trusts for people diagnosed between 1st January 2018 and 31st July 2022. For the data quality metrics that use COSD, we have included the latest 21 months of data in this quarterly report except we have not included July 2022 so that we could align with the quarters by calendar year (Q1 = Jan-Mar; Q2 = Apr-Jun; Q3 = Jul-Sep; Q4 = Oct-Dec).

Why have we focused on data completeness?

This is the first 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.

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

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

Clinical nurse specialist – 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 – 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 – as it is important in kidney cancer for assessing the eligibility of patients for different treatments.

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

Morphology – as it could allow us to explore kidney cancer sub-types.

Performance status – 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.

For any queries relating to the audit, please email: [email protected]

Last updated: 10 April 2024, 7:56am