NPCA Quarterly Report July 2020 to June 2023 (published May 2024)

The purpose of the National Prostate Cancer Audit (NPCA) is to evaluate the patterns of care and outcomes for patients with prostate cancer in England and Wales, and to support services to improve the quality of care for these patients.

This data viewer provides an overview of the quality of key data items captured for 135,056 people diagnosed with prostate cancer in England between July 2020 to June 2023.

This is the second quarterly report published by the NPCA team. The first quarterly report covered patients diagnosed between January 2020 to December 2022 which can be found below. For this quarterly report, the NPCA 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. It is worth noting that RCRD and COSD do not have complete coverage of all patients diagnosed with prostate cancer in England during the reporting period.

The NPCA quarterly report will initially include data quality metrics only. Going forward, the NPCA 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 prostate cancer patient diagnostic pathway, treatments, and outcomes. We have conducted some initial methodological development work comparing the RCRD and NCRD for four NPCA annual performance indicators; this methodological update can be found below.

Why have we focused on data completeness?

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 patients 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 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.

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.

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.