NLCA 2016 annual report: changes to Cancer Outcomes and Services Dataset data collection in England

Furthermore, NCRAS is now able to identify a substantial number of ‘extra cases’ (approximately 6,000 in England for 2015) compared with historical Lung Cancer Audit Dataset (LUCADA) records. Naturally, trusts have questioned why their data include more cases than they were expecting, and local analysis has confirmed that these are real cases that have been appropriately allocated, but that they were not picked up by the multidisciplinary team (MDT) for a variety of reasons. The NLCA will continue to include these cases because the audit is commissioned to report on all cases of lung cancer, and not just those known to the MDTs.

Lung cancer care is increasingly complex, and it is now not unusual for patients to move across different organisations for their diagnosis and treatment. Historically, we have always tried to allocate patients to the ‘trust first seen’ because this is usually the site of the decision-making MDT, and the same approach is appropriate for the cancer registration data. Unfortunately, in around 18% of patients these data are missing, and some cases have conflicting entries. In order that these cases are not lost to the audit analysis, we have developed an algorithm that uses other data supplied to NCRAS to determine the most likely ‘trust first seen’. Testing of the algorithm shows that it is very accurate, although inevitably some errors do occur. We urge trusts to ensure that the ‘trust first seen’ field is completed accurately in their COSD submissions.

The NLCA team welcome feedback, both good and bad, and we always try to respond constructively. For those organisations that are still struggling with discrepancies between data they submit and data in the annual report, local NCRAS data improvement leads can supply patient-level data to help them to understand it.

Paul Beckett, NLCA clinical lead

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