This Standard Operating Procedure (SOP) is intended to describe the methodology used to build the underlying data set used in the NDRS cancer treatment dashboard, to aid the interpretation of the tool, as well as allow others to replicate results using standardised methodology. To navigate to a specific section of the documentation, please use the contents list to the left-hand side of the page. Some sections consist of a set of tabs, please click on each tab to see more information.

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About the NDRS

The National Disease Registration Service (NDRS) is part of NHS England (NHSE). Its purpose is to collect, collate and analyse data on patients with cancer, congenital anomalies, and rare diseases. It provides robust surveillance to monitor and detect changes in health and disease in the population. NDRS is a vital resource that helps researchers, healthcare professionals and policy makers make decisions about NHS services and the treatments people receive.

The NDRS includes:  

  • The National Cancer Registration and Analysis Service (NCRAS); and  
  • The National Congenital Anomaly and Rare Disease Registration Service (NCARDRS). 

Healthcare professionals, researchers and policy makers use data to better understand population health and disease. The data is provided by patients and collected by the NHS as part of their care and support. The NDRS uses the data to help: 

  • understand cancer, rare diseases and congenital anomalies; 
  • improve diagnosis; 
  • plan NHS services; 
  • improve treatment; 
  • evaluate policy; 
  • and improve genetic counselling.   

National Disease Registration Service
The Leeds Government Hub
7&8 Wellington Place
Leeds
LS1 4AP

For queries relating to this document, please contact us via the NDRS Contact Page.

Introduction

 

This Standard Operating Procedure (SOP) (4v10) updates the previous version (v4.9.1) to include tumours diagnosed in 2022. This version also adds tumour resections for:

  • Blood cancer (haematological neoplasms)
  • Eye cancer
  • Heart, mediastinum, pleura, other and ill-defined cancer
  • Mesothelioma cancer
  • Thymus cancer

Also within this version, the previously named ‘chemotherapy’ treatment category is named ‘SACT’ (Systemic Anti-Cancer Therapy). Additional treatment codes have been included within this SACT definition, including immunotherapy and combination therapies. An additional treatment code for proton therapy has been added to the radiotherapy definition.

Some site definitions have changed to align with other NDRS outputs. The kidney and colon definitions do not align, due to more extensive reviews taking place to align these definitions.

The purpose of this SOP is to describe the method of linking treatment tables to the cancer registration data in the Cancer Analysis System (CAS). This allows basic treatment flags to be created; recording whether there was radiotherapy, SACT, or tumour resection recorded following a cancer diagnosis.

The data is available in CAS: av2022.av_treatment_table_1322_4p10 in casref02.

These treatment flags are presented by demographic factors and by Cancer Alliance in the Radiotherapy, SACT and Tumour Resections in England, 2013-2022 publication.

The cancer sites included are those which have pre-defined lists of relevant tumour resection procedures, with the exception of the ‘Other haematological neoplasms’ group. The term ‘tumour resection’ (previously termed ‘major resection’ in other outputs) is used to describe surgical attempts to remove the primary tumour. For blood cancers (haematological neoplasms), although some do form solid tumours, many do not form a solid lump or growth, and therefore are not resectable. The procedures included in the definition for tumour resections for blood cancers may include blood transplants to support accurate capture of information for first-line treatment. All other sites - those without defined tumuor resection procedures - are grouped under either ‘other malignant’ or ‘other non-malignant’ tumours.

Cancer site and treatment-specific timeframes have been adopted to strike a balance between including as many treatments as possible carried out as part of the patient’s first course of treatment for that tumour, whilst minimising the inclusion of treatments for recurrent tumours.

This SOP is to be used where the analyst wishes to extract data on treatments among cancer types listed (see Appendix 2). The cancer sites with a tumour resection flag have been chosen because they are solid tumours, and so are potentially resectable (with the exception of certain haematological neosplasms as detailed above); are commonly diagnosed; and input from a site-specific clinician was available. Expansion of this list to include more cancer sites, where resection is a treatment choice, will be considered for future NDRS work. SACT and radiotherapy data was available for all cancer sites. This SOP exists to set a standard that can be followed to produce uniform and replicable results, in particular for external requests for treatment data received via the NHSE Data Access Request Service (DARS). Certain projects may require a different approach and should be discussed with a senior NDRS analyst.

The changes to the code since the previous release are summarised in Appendix 1 of this document. The ICD10 codes used for tumour sites, treatment timeframe rules, and resection procedure codes are provided in Appendices 2 and 3. All SQL and R code for producing the publication is available in the Cancer-Treatments GitHub repository. The SQL code produces tumour-level data with 3 treatment flags; radiotherapy, SACT, and tumour resection (RT, CT, and SG in the CAS table, respectively), with 0 as no treatment and 1 where treatment was received.

Methodology

Cohort definition

Cancer registry data from AT_TUMOUR_ENGLAND was used to identify the cohort of patients. All patients diagnosed with malignant cancer, and some non-malignant tumours, as listed in Appendix 2, in England between 2013 and 2022 were included. Males with gynaecological cancer and females with prostate cancer were excluded from the published data. This may have excluded some transgender and non-binary patients. The NDRS Inequalities in cancer webpage provides more details. Death certificate only registrations are included (1% of the cohort).

Overall approach to identify treatments

The data sets used to collate treatment data are AT_TREATMENT_ENGLAND, SACT (Systemic Anti-Cancer Therapy), RTDS (radiotherapy data set), and inpatient (Admitted Patient Care (APC)) HES (Hospital Episode Statistics) and outpatient (OP) HES.

The AT_TREATMENT_ENGLAND table is linked at tumour level, based on registration staff linking tumours to recorded treatments. Appendix 4 details the datasets and snapshots used in this update.

The scope of this SOP is tumours diagnosed from 2013 onwards as it is known that the data quality in AT_TREATMENT_ENGLAND and SACT is lower before this point. However, treatment flags for select groups (e.g., childhood cancers) may be fairly complete in AT_TREATMENT_ENGLAND for earlier years. Cancer Waiting Times (CWT) data is not currently used. This decision was made following an assessment of the coverage of the data sets, and as ≥98% of radiotherapy and ≥94% of SACT were captured by the cancer registry, SACT and RTDS in the period October 2012 to March 2013 (with the data completeness believed to be increasing since) it did not justify the complication of including CWT data.

For patients with one tumour diagnosed in 2013-2022, and patients with multiple tumours diagnosed more than eighteen months apart, data from both the tumour linked treatment table (AT_TREATMENT_ENGLAND) and the patient linked treatment tables (RTDS, SACT and HES) are used. However, for patients with two or more tumours diagnosed within eighteen months of each other, only data from the tumour linked treatment table (AT_TREATMENT_ENGLAND) is used. This is because RTDS, SACT and HES can only identify the person that had the treatment, and not the specific tumour. The current scope of this SOP is to define a working methodology for counting treatments in the absence of tumour level linked data. Currently RTDS, SACT and HES data are linked at patient level and while the tumour that any treatment data applies to (where a patient has multiple tumours) can be inferred it is not definitively linked. This may be modified as and when further tumour-linked treatment data becomes available.

Tumours which received the same treatment more than once are only counted once.

Early stage tumour resections

Lists of procedure codes (OPCS-4 codes) which would be used to remove the primary tumour were defined in consultation with experienced clinicians. Stage-specific rules have been incorporated for relevant sites and OPCS-4 procedure codes.

For pancreatic tumours, a much lower proportion than expected of early stage tumours are recorded to have been resected. Further investigation is needed to understand whether all resections are being captured by the data and methodology.

The full tumour resection list is available in Appendix 3. The following table shows the procedures which were identified as tumour resections in early stage disease only, or for specific tumour types:

See Appendix 5 for a sensitivity analysis showing the impact of adding stage-specific tumour resections.

Timeframe

NCRAS follows European Network of Cancer Registries (ENCR) rules to define the date of diagnosis. This may be sourced from several data items including the date of the first pathological report confirming the tumour (although the date the pathological sample was taken is preferred, if available). This means that date of diagnosis can be shortly after a tumour resection. To avoid excluding relevant data, treatments in the one month (-31 days inclusive) prior to diagnosis were included in the analysis.

A data-driven approach with additional input from site-specialist clinicians was used to decide a site- and modality- specific post-diagnosis timeframe. The timeframe was chosen to be long enough to capture as many treatments as possible as part of the patient’s primary course of treatment, while also minimising the inclusion of treatments for recurrence. This SOP counts treatments between one month before, to up to eighteen months after diagnosis, with the exact timeframe depending on the site and treatment type. For patients who received each treatment for each cancer, the number of days after diagnosis at which 95% of these patients received the treatment was identified. This was rounded up to the nearest three-month interval, and this timeframe cut off was applied. Post-diagnosis timeframes were therefore 6, 9, 12, 15 or 18 months.

For example, of the pancreatic tumours diagnosed in 2013-14 which received a tumour resection within two years of diagnosis, 95% had their resection within 226 days. Therefore, for all pancreatic cancers diagnosed in 2013-2022, a post-diagnosis tumour resection timeframe of 274 days (9 months) was applied. Exceptions to the data driven approach were made for particular treatments for certain cancer sites under recommendation from clinicians. For these sites, clinicians decided the timeframe using a combination of their own experience and the data. See Appendix 2 for details, and Appendix 6 for a sensitivity analysis showing the impact of changing the timeframes.

Relative to other tumour sites, treatment data quality for non-melanoma skin cancers (NMSC) (BCC, cSCC and rare tumours) is poor. A data-driven approach failed to identify 95% of SACT and radiotherapy treatments within an appropriate timeframe. Clinician input was therefore used to decide suitable timeframes for treatment periods, with the view that quantifying the current state of treatment data can be used as a base to improve overall data quality. These figures for NMSC should therefore be considered provisional and are expected to be incomplete.

See Appendix 6 for a sensitivity analysis for timeframes.

SQL rules used to identify treatments

The standard operating procedure ‘CAS-SOP #1: Counting Cancer Cases’ was used to define the cancer diagnoses cohort. This SOP applies to CAS1612 onwards, as it uses the newly categorised treatments implemented in December 2016.

Radiotherapy

A tumour is recorded as treated with radiotherapy if:

  • there is a record in AT_TREATMENT_ENGLAND which states that the tumour was treated with radiotherapy, defined as any one of:

    • Chemoradiotherapy (code = 04)
    • RT - Teletherapy (code = 05)
    • Brachytherapy (code = 06)
    • Proton Therapy (code = 13)
    • Radioisotope therapy (including radioiodine) (code = 19)
    • Radiosurgery (code = 22)
    • RT - Other/NK (code = RTX)

  • and the event date (EVENTDATE) occurred in the relevant timeframe (see Appendix 2)

OR

  • there is a record in RTDS (including for ‘brachytherapy’ (RTTREATMENTMODALITY=06))
  • and the appointment date (APPTDATE) occurred in the relevant timeframe
  • and the patient had no other tumours diagnosed in the 18 months before or after that tumour’s diagnosis date

RTDS is linked to the cancer registration using a matching algorithm taking into account NHS number, date of birth, gender and postcode at diagnosis (details available on request to NDRS).

From 1 April 2016, NHSE (previously Public Health England) took over full responsibility for RTDS, allowing greater integration of the management, collection, quality assurance and analysis of radiotherapy data alongside the other major national cancer data sets in its charge. For patients whose follow up period for radiotherapy extended past April 2016, the RTDS.AT_PRESCRIPTIONS_ENGLAND dataset in CAS2504 was used.

See the published Data Profile for RTDS for further information.

SACT

A tumour is recorded as treated with SACT if:

  • there is a record in AT_TREATMENT_ENGLAND which states that the tumour was treated with SACT, defined as any one of:

    • Cytotoxic Chemotherapy (code = 02)
    • Anti-cancer drug regimen (Cytotoxic and Hormone) (code = 02_03)
    • Anti-cancer drug regimen (Cytotoxic and Immunotherapy) (code = 02_15)
    • Anti-cancer drug regimen (Cytotoxic and Biological Therapies) (code = 02_21)
    • Anti-cancer drug regimen (Immunotherapy and Hormone) (code = 03_15)
    • Anti-cancer drug regimen (Biological Therapies and Hormone) (code = 03_21)
    • Chemoradiotherapy (code = 04)
    • Anti-cancer drug regimen (Other) (code = 14)
    • Immunotherapy (code = 15)
    • Immunotherapy (code = 15_21)
    • Biological Therapies (excluding Immunotherapy) (code = 21)
    • CT - Other (code = CTX)

  • and the event date (EVENTDATE) occurred in the relevant timeframe (see Appendix 2)

OR

  • there is a record in inpatient or outpatient HES with a OPCS-4 code in: Y123, X962, X749, X748, X739, X738, X731, X729, X728, X724, X723, X722, X721, X719, X718, X715, X714, X713, X712, X711, X709, X708, X705, X704, X703, X702, X701, X385, X384, X374, X373, X353, X352, T482, T133, or A106
  • and the operation date (OPERTN) occurred in the relevant timeframe
  • and the patient only had one tumour in the time period of interest

OR

  • there is a record in SACT (excluding those null or classified as 'Hormones' or 'Not chemo' or 'Zoledronic acid' or 'Pamidronate' or 'Denosumab' or ‘Radium 223’ or ‘Lutetium-177’ or ‘Yttrium-90’)
  • and the start date of the regimen (START_DATE_OF_REGIMEN) occurred in the relevant timeframe
  • and the patient had no other tumours diagnosed in the 18 months before or after that tumour’s diagnosis date

SACT treatments are extracted from AT_TREAMENT_ENGLAND, SACT, plus HES inpatient and outpatient data.

SACT is linked to cancer registration where NHS numbers are a perfect match. Regimen mappings are based on both those directly confirmed by trusts, and those assigned by the SACT team (for example where trusts haven’t addressed unmapped regimens).

HES is linked to the cancer registration using a matching algorithm taking into account NHS number, date of birth, gender and postcode at diagnosis (details available on request to NDRS).

Please note that oral SACT treatments are under reported, which will affect the completeness of the data for these treatments. See the published Data Resource Profile for SACT for further information.

Tumour resections

A tumour is recorded as treated by resection if:

  • there is a record in AT_TREATMENT_ENGLAND which states that the tumour was treated with surgery, defined as any one of:

    • Surgery - curative (code = 01a)
    • Surgery - not curative (code = 01b)
    • Surgery - investigative (code = 01c)
    • Surgery etc - type unknown (code = 01z)

  • and the OPCS4_CODE is in the tumour resection list (Appendix 3)

  • or the OPCS4_CODE is identified as a tumour resection in early stage tumours for that specific cancer site (see Appendix 3)

  • and the operation date (OPERTN) occurred in the relevant timeframe (see Appendix 2)

OR

  • there is an inpatient or outpatient HES episode with a tumour resection OPCS-4 code (defined in Appendix 3) in one of the operation fields
  • or one of the operation fields contains an OPCS-4 code identified as a tumour resection in early stage tumours for that specific cancer site (see Appendix 3)
  • and the operation date (OPERTN) occurred in the relevant timeframe
  • and the patient had no other tumours diagnosed in the 18 months before or after that tumour’s diagnosis date

HES is linked to the cancer registration using a matching algorithm taking into account NHS number, date of birth, gender and postcode at diagnosis (details available on request to NDRS).

Dashboard breakdowns

Results are broken down by tumour sites; the ICD10 codes used to define these can be found in Appendix 2. Definitions for bladder cancer can be found in the Bladder cancer documentation, for skin cancer in the Skin tumours documentation, and for haematological subsites in the Blood cancer (haematological neoplasms) documentation.

Stage breakdowns reflect the stage at diagnosis, based on TNM staging rules. Site-specific staging classifications (when available) are used in preference of TNM. For cervical cancers (C53), only FIGO staging was used. The final recorded stage of a tumour is derived by the registration service using information provided by the trusts including pathology/clinical investigations where necessary. For this reason, the tumour stage shown in this data may be different to the stage originally available to the clinician when deciding a course of treatment, as it may have been subsequently updated following removal of the tumour and pathology results.

The patient’s age group was based on the age of the patient at the point of diagnosis.

The patient’s gender was based on the self-stated gender of the patient, and not phenotypic sex, at the point of diagnosis.

The patient’s Index of multiple deprivation (IMD) quintile was allocated by linking the patient’s postcode at the point of diagnosis to their 2021 ONS census Lower Super Output Area (LSOA). This was then linked to the Ministry of Housing, Communities & Local Government English Indices of Deprivation equal LSOA weighted quintile for that LSOA and appropriate year (2015 quintiles were using for diagnoses in 2013, 2019 quintiles were used for diagnoses after 2013).

The patient’s Charlson comorbidity score was derived from Hospital Episodes Statistics (HES) and cancer registry data combined and looks back at the time period between 27 months to 3 months before the patient’s cancer diagnosis.

The patient’s ethnic group was based on self-reported ethnicity of the patient at the point of diagnosis. The ethnic groups ‘Mixed’ and ‘Other’ are combined into an ‘Other’ ethnicity group.

The patient’s Cancer Alliance was allocated based on their Cancer Alliance of residence at point of diagnosis, not the location(s) where they were treated.

Appendices

Appendix 1: Code changes in SOP version 10 compared to 4.9.1

Changes have been made to the extraction code and lookups in SOP version 10 since the previous version, SOP version 4.9.1, was published. These are noted below. Only non-superficial changes are noted; i.e. changes that could potentially impact the results.

Timeframe rules

Changes to the head and neck sites due to the differences in site definitions (described in the ‘Tumour cohort table’ tab):

  • Larynx: SACT increased from 12 to 18 months
  • Oral cavity: SACT increased from 15 to 18 months, and radiotherapy decreased from 15 to 12 months

Tumour cohort table

The Snapshot used for AT_TUMOUR_ENGLAND and AT_TREATMENT_ENGLAND was updated to AV2022.

Tumours were extracted with diagnoses between 2013-2022.

Cancer group updates:

Additional sites now presented:

  • Thymus (ICD10 C37)
  • Heart, mediastinum, pleura, and other and ill-defined ( ICD10 C38 and C39)
  • Mesothelioma (ICD10 C45)
  • Eye (ICD10 C69)

Haematological neoplasms are now presented as eighteen groups, these are:

  • Acute lymphoblastic leukaemia (ALL)

  • Acute myeloid leukaemia (AML)

  • Chronic myelomonocytic leukaemia (CMML)

  • Hodgkin lymphoma

  • Lymphoproliferative disorders and non-specific

  • Mature T-cell and NK-cell neoplasms

  • Chronic myeloid leukaemia (CML)

  • Chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL)

  • Diffuse large B-cell lymphoma (DLBCL) and other high grade mature B-cell neoplasms

  • Follicular lymphoma

  • Mantle cell lymphoma (MCL)

  • Myelodysplastic syndromes (MDS)

  • Myeloma

  • Other Myeloproliferative neoplasms (MPN)

    • All Myeloproliferative neoplasms, excluding: Chronic myeloid leukaemia

  • Other Mature B-cell neoplasms:

    • All Mature B-cell neoplasms, excluding: Chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL), Diffuse large B-cell lymphoma (DLBCL) and other high grade mature B-cell neoplasms, Follicular lymphoma, and Mantle cell lymphoma (MCL)

  • Other Plasma cell neoplasms:

    • All Plasma cell neoplasms excluding: Myeloma

  • Other myeloid:

    • Acute promyelocytic leukaemia
    • Other myeloid neoplasms
    • Mastocytosis

  • Other haematological neoplasms (presents radiotherapy and SACT only):

    • Histiocytic and dendritic cell neoplasms
    • Neoplasms and leukaemias of ambiguous lineage
    • Langerhans cell histiocytosis (LCH)

These sites are all tagged as ‘experimental’, whilst we receive any additional feedback on these statistics and the associated methodology.

Definitions for haematological subsites can be found in the Blood cancer (haematological neoplasms) documentation.

Some sites have been amended to align with AT_SITE_ENGLAND:

  • Brain:

    • Brain: Non-malignant brain, now includes D18 and excludes D44

  • Bladder, now split into five groups:

    • Malignant bladder non invasive Ta/TIS
    • Malignant bladder non invasive T1
    • Malignant bladder invasive
    • Malignant bladder invasion not known
    • Uncertain/unknown or other bladder

For further information on the bladder groups, please see the Bladder cancer documentation.

  • Stomach - previously defined as C16. Now for tumours diagnosed between 2013 and 2017, stomach is defined as C16 excluding C16.0. Whereas for 2018 onwards, it is C16 excluding C16.7.

  • Oesophagus - previously defined as C15. Now for tumours diagnosed between 2013 and 2017, oesophagus is defined as C15 plus C16.0. Whereas for 2018 onwards, it is C15 plus C16.

  • Head and neck:

    • Larynx, previously defined as C32 now also includes C101
    • Oral cavity - previously defined as C02, C03, C04, C05, now also includes C00 and C050
    • Oropharynx - previously defined as C01, C09, C10, now also includes C024 and C051-C059
    • Other head and neck - no longer includes C050-C059


Kidney and colorectal cancer type definitions do not align to AT_SITE_ENGLAND, due to more extensive reviews taking place for these definitions.

For full site definitions in AT_SITE_ENGLAND, see the Standard cancer group definitions - NDRS.

Data fields

No additional fields.

The full code for producing the field outputs is publicly available on GitHub: Cancer-Treatments GitHub repository.

Radiotherapy flag

The snapshot used for AT_TREATMENT_ENGLAND was updated to AV2022. The snapshot used for the RTDS dataset post-April 2016 was updated to CAS2504.

SACT flag

The snapshot used for AT_TREATMENT_ENGLAND was updated to AV2022. The snapshot used for the SACT dataset post-July 2017 was updated to CAS2504.

Tumour resection flag

The snapshot used for AT_TREATMENT_ENGLAND was updated to AV2022.

Tumour resection procedures are additionally defined and presented for:

  • Thymus
  • Heart, mediastinum, pleura, and other and ill-defined
  • Mesothelioma
  • Eye
  • Haematological neoplasms*

*Note that tumour resections are not defined for ‘Other haematological neoplasms’ (which includes ‘Histiocytic and dendritic cell neoplasms’, ‘Neoplasms and leukaemias of ambiguous lineage’, and ‘Langerhans cell histiocytosis (LCH)’). This is due to small counts, and lack of relevant procedures. The tumour resection definition for haematological neoplasms also includes relevant transplant procedures.

Newly published sites are tagged as ‘experimental’, whilst we receive any additional feedback on these statistics and the associated methodology.

(NMSC although not newly published are also tagged as experimental because they are considered provisional due to low data quality for these cancer types).

See appendix 3 for a complete list of resection codes used.

Appendix 2: Summary of tumour sites and timeframe rules

The following ICD10 codes and post-diagnostic treatment time periods were used for the cancer sites presented. The time periods were identified using a data driven approach, with exceptions (*) made for particular treatments for certain cancer sites under recommendation from clinicians. These timeframes were chosen by clinicians using their own experience and the data.

1 Please refer to the Bladder cancer documentation for full details on how bladder cancer types are defined.

2 Please refer to the the Skin tumours documentation for full details on how skin tumours, in particular non-melanoma skin cancers (NMSC) are defined.

3 Please refer to the the Blood cancer (haematological neoplasms) documentation for full details on how haematological neoplasms are defined. Haematological transformations are excluded.

Appendix 3: Cancer type-specific summary of tumour resection rules

Appendix 4: Data sets used

Appendix 5: Sensitivity analysis – impact of tumour resection code update

The list of relevant tumour resection codes was updated for SOP (v4.4) and previous versions of CAS-SOP#4, from a previous list that did not include stage-specific resections. Please note, this analysis is from SOP (v4.4) and has not been updated for this v10 SOP update. Below is a comparison of the previous coding used and the current version, which includes stage-specific resections. The previous code list was applied to the current sites (selected with the same ICD10 codes), and the same timeframes obtained from this SOP.

 

Findings

  • For the 22 cancer types with defined tumour resections codes, 41% of tumours had a tumour resection using the previous list of codes, and 45% had a tumour resection when using the updated list of codes, plus the site-specific additions (as listed in Appendix 3).
  • Statistically significant differences between the proportions are present for all but three of the 22 sites (non-small lung cancer, small cell lung cancer and uterine cancers).
  • The differences are most noticeable for bladder cancer (36% absolute difference), cervical (14% absolute difference), salivary glands (13% absolute difference), liver (13% absolute difference), and other head and neck (12% absolute difference).

Appendix 6: Sensitivity analysis – impact of timeframe update

The timeframes as defined above may not capture all treatments for certain cancer sites (underestimate of true figure) or include treatments for recurrence (overestimate of true figure). Therefore, follow-up periods of 6/12/18 months were tested and the results are shown below. Please note, this analysis is from SOP (v4.4) and has not been updated for this v4.9 SOP update.

 

Radiotherapy

SACT

Tumour Resection

Findings

  • Overall across all sites (excluding NMSC), 27% of tumours received chemotherapy within six months of diagnosis, increasing to 29% within 12 and 18 months. Sites with the greatest absolute differences in proportions from six to 18 months are bladder, kidney, liver, oral cavity, rectum and other (3-4% absolute difference).
  • Of the 22 cancer sites with defined tumour resections codes (excluding ‘Other’ sites), 43% of tumours received a tumour resection within six months of diagnosis, increasing to 45% within 12 and 18 months. Sites with the greatest absolute differences in proportions from six to 18 months are rectum, breast, hypopharynx and oropharynx (5-9% absolute difference).
  • Overall across all sites (excluding NMSC), 20% of tumours received radiotherapy within six months of diagnosis, increasing to 28% within 12 months and 29% within 18 months. Sites with the greatest absolute differences in proportions from six to 18 months are breast, prostate, small cell lung cancer and oesophageal (8-26% absolute difference).