Registry-derived stage (RD-Stage) for capturing cancer stage at diagnosis for endometrial cancer

S M Evans; K Ivanova; R Rome; D Cossio; Chc Pilgrim; J Zalcberg; Y Antill; L Blake; A Du Guesclin; A Garrett; D Giffard; N Golobic; D Moir; S Parikh; A Parisi; K Sanday; C Shadbolt; M Smith; L Te Marvelde; K Williams

doi:10.1186/s12885-023-11615-6

Registry-derived stage (RD-Stage) for capturing cancer stage at diagnosis for endometrial cancer

BMC Cancer. 2023 Dec 12;23(1):1222. doi: 10.1186/s12885-023-11615-6.

Authors

S M Evans¹, K Ivanova², R Rome³, D Cossio⁴, Chc Pilgrim⁵, J Zalcberg⁶, Y Antill⁷, L Blake², A Du Guesclin⁸, A Garrett⁹, D Giffard⁴, N Golobic⁴, D Moir⁸, S Parikh², A Parisi¹⁰, K Sanday⁹, C Shadbolt¹¹, M Smith¹⁰, L Te Marvelde², K Williams²

Affiliations

¹ Cancer Council Victoria, Melbourne, Australia. sue.evans@cancervic.org.au.
² Cancer Council Victoria, Melbourne, Australia.
³ Epworth Health Care, Melbourne, Australia.
⁴ Cancer Alliance Queensland, Woolloongabba, Australia.
⁵ Central Clinical School, Department of Surgery, The Alfred, Monash University, Melbourne, Australia.
⁶ School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
⁷ Monash University, Melbourne, Australia.
⁸ Department of Anatomical Pathology, The Alfred, Melbourne, Australia.
⁹ Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
¹⁰ ACT Cancer Registry Australian Capital Territory Health, Deakin, Australia.
¹¹ Royal Women's Hospital, Melbourne, Australia.

Abstract

Background: Capture of cancer stage at diagnosis is important yet poorly reported by health services to population-based cancer registries. In this paper we describe current completeness of stage information for endometrial cancer available in Australian cancer registries; and develop and validate a set of rules to enable cancer registry medical coders to calculate stage using data available to them (registry-derived stage or 'RD-Stage').

Methodology: Rules for deriving RD-stage (Endometrial carcinoma) were developed using the American Joint Commission on Cancer (AJCC) TNM (tumour, nodes, metastasis) Staging System (8^th Edition). An expert working group comprising cancer specialists responsible for delivering cancer care, epidemiologists and medical coders reviewed and endorsed the rules. Baseline completeness of data fields required to calculate RD-Stage, and calculation of the proportion of cases for whom an RD stage could be assigned, was assessed across each Australian jurisdiction. RD-Stage (Endometrial cancer) was calculated by Victorian Cancer Registry (VCR) medical coders and compared with clinical stage recorded by the patient's treating clinician and captured in the National Gynae-Oncology Registry (NGOR).

Results: The necessary data completeness level for calculating RD-Stage (Endometrial carcinoma) across various Australian jurisdictions varied from 0 to 89%. Three jurisdictions captured degree of spread of cancer, rendering RD-Stage unable to be calculated. RD-Stage (Endometrial carcinoma) could not be derived for 64/485 (13%) cases and was not captured for 44/485 (9%) cases in NGOR. At stage category level (I, II, III, IV), there was concordance between RD-Stage and NGOR captured stage in 393/410 (96%) of cases (95.8%, Kendall's coefficient = 0.95).

Conclusion: A lack of consistency in data captured by, and data sources reporting to, population-based cancer registries meant that it was not possible to provide national endometrial carcinoma stage data at diagnosis. In a sample of Victorian cases, where surgical pathology was available, there was very good concordance between RD-Stage (Endometrial carcinoma) and clinician-recorded stage data available from NGOR. RD-Stage offers promise in capturing endometrial cancer stage at diagnosis for population epidemiological purposes when it is not provided by health services, but requires more extensive validation.

Keywords: (MeSH Headings) registries; Cancer; Cancer registries; Epidemiology; Neoplasm staging; TNM Stage.

MeSH terms

Australia / epidemiology
Endometrial Neoplasms* / diagnosis
Endometrial Neoplasms* / epidemiology
Female
Humans
Neoplasm Staging
Registries
United States