Quality and Performance Monitoring

Page contents

• Peer Review of Cancer Registries
• Performance Monitoring

Peer Review of Cancer Registries

Since the publication in 2004 of the national document, The Manual for Cancer Services, a further set of measures was developed so that Cancer Registries could be included in the peer review process, alongside cancer service providers. The Registry Measures were originally published in October 2004, with a further amended version released in November 2005.

Peer review for cancer registries is an assessment of the quality of cancer registration in England and Northern Ireland, undertaken by specialist teams of professional peers (colleagues in other registries working in the same discipline) and cancer service user reviewers. The process is overseen and coordinated by a national Quality Director and Quality Manager.

Trent Cancer Registry had a peer-review team visit in April 2007.

The final Peer Review Report and supporting Action Plan was published in July 2007.

Performance Monitoring

In order to closely monitor the quality of the data on the Registry’s database and highlight any potential problem areas, we extract and analyse specific sets of data on a regular basis. The three main indicators of quality that we monitor are ascertainment (level of cancer incidence registered), timeliness (how quickly the cases are registered) and the proportion of death certificate only registrations (DCOs) on the database. Regular reports on performance monitoring are presented to the Trent Cancer Registry Steering Group. We are also required to submit performance indicator data for use in the production of a United Kingdom Association of Cancer Registries (UKACR) annual report, along with all other UK cancer registries.

Ascertainment: the level of cancer incidence registered.

• The table below shows the number of registrations on our database as at 30th June 2009 for all cancers (excluding non-melanoma skin) diagnosed between 2004 and 2007 in residents of the Registry’s catchment population.  The “%change” is the percentage difference in the numbers of registrations made in that year, compared with the previous year.
• An increasing trend in cancer registrations can be the result of improvements in a registry’s ability to capture cases and does not necessarily mean that more cases of cancer have been diagnosed. The figures presented here reflect better ascertainment of cases from some hospitals and an increase in the number of suppliers of pathology data to us in earlier years, followed by a more stable rate of cancer registration in recent years.

Registrations of all malignant cancers (excluding non-melanoma skin), 2004-2007 and %change from previous year

Timeliness: a measure of how quickly cancer registries make registrations.

• The national target for timeliness requires registries to submit registrations to the Office for National Statistics (ONS) for all cancers diagnosed in a calendar year within 18 months of the end of that year.
• We met the timeliness target for submission of 2007 cases to ONS. In fact, most of our cases are registered within twelve months, with a large proportion within six (see chart below).

Death Certificate Only (DCO) rate: the percentage of cases for which the only source of information was a death notification.

• The national target for DCO rate is just 2% because registrations made from a death notification only may lack important information, such as an accurate date of diagnosis, tumour morphology or stage of the tumour. A high percentage DCO also suggests low case ascertainment.
• The chart below shows that we have made significant progress over the years to reduce the proportion of DCO registrations on our database and achieved the target for 2007 diagnosed cases.