The CRUK-NCRAS partnership: improving outcomes through cancer intelligence

Our partnership 

More than one in two people in the UK are diagnosed with cancer at some point in their lifetime and cancer is the main cause of death in the UK. Yet we are only beginning to understand how patients use services up to diagnosis, how factors such as stage at diagnosis, treatment and comorbidity affect cancer survival, and how patients experience their cancer journey.

In 2013 Cancer Research UK (CRUK) and the National Cancer Intelligence Network (NCIN) established a partnership to conduct analyses that both organisations see as priorities in providing intelligence to support improved patient outcomes. The National Cancer Registration and Analysis Service (NCRAS) continues this partnership, expanding its remit and scope to cover new areas of analysis and research.

This partnership brings together the strengths of both organisations and is one small step towards saving 5,000 lives a year. Recent developments in the extent and accessibility of cancer data have provided CRUK and NCRAS with the opportunity to enhance understanding of the patient pathway and, as a result, to support improvements in cancer service delivery and outcomes for patients.

Our priorities

The work of the partnership analysts funded by CRUK is integrated into the NCRAS Analytical Work Programme. The partnership steering group meets four times a year to agree the priorities that the partnership analysts should focus on.  These include but are not limited to:

  • Exploring Routes to Diagnosis further, including an analysis of Routes by Stage
  • Delving further into emergency presentations, including the impact that awareness and early diagnosis initiatives may have had
  • Analysing cancer outcomes, from diagnosis through treatment and beyond
  • Exploring the relationship between the Cancer Patient Experience Survey results and patient outcomes
  • Investigating how inequalities in gender and deprivation affect cancer incidence and mortality
  • Analysing treatment pathways
  • Exploring the Diagnostic Imaging Dataset (DIDs)

Our progress

June 2013: we publish our comparative report of NCIN's and the National Audit of Cancer Diagnoses in Primary Care's (NACDPC) routes to diagnosis analysis; Routes to Diagnosis: Comparing multiple studies - see our publications below

May 2014: publication of report on deprivation; Cancer by deprivation in England 1996-2011 - see our publications below

August – May 2015: focus on publication of major resection short report along with workbook

June 2015: publication of report on Major resections by cancer sites; Major resections by routes to diagnosis (2006 to 2010; England) - see our publications below

August 2015 – February 2016: focus on publication of Routes to Diagnosis by Stage

February 2016: publication of Routes to Diagnosis by stage workbook - see our publications below

March 2016 - Present: focus on ethnicity and stage workbook and data briefing

Our publications

Ethnicity and stage at diagnosis data briefing

The completeness and availability of ethnicity and stage at diagnosis data in Public Health England’s (PHE) cancer registration system for England has improved in recent years. This has enabled us to analyse in detail the variation in the proportion of stage at diagnosis in each ethnic group. This data briefing presents data on residents in England diagnosed with lung (ICD-10 C34), breast (C50, males and females included), colorectal (C18-20) and prostate (C61) cancer in 2012 and 2013.

The workbook presents the proportions for stage at diagnosis 1,2,3,4 and stage unknown, as well as the proportions for early stages (1 and 2) and late stages (3 and 4).

 

Routes to diagnosis of cancer by stage, 2012-2013

This spread sheet provides the proportion of cancer cases by stage at diagnosis for patients presenting via each of the six presentation routes, for 2012, 2013 and 2012-2013 combined. Detailed information is provided for 10 cancer sites.

Data are stratified by sex, age, socio-economic deprivation quintile and ethnicity. For further information on the methods and caveats, please see the workbook.

Report: Major resections by routes to diagnosis (2006 to 2010; England)

This report presents major resection rates - the proportion of patients who have had surgery to remove a cancer between 2006 and 2010 - by Route to Diagnosis and by sex in England, for a wide range of cancers. It has been produced by the National Cancer Intelligence Network (NCIN) in partnership with Cancer Research UK (CRUK).

The NCIN’s Routes to Diagnosis study (Elliss-Brookes et al., 2012) has been instrumental in showing the proportion of patients that present through different routes. This new analysis combines these data with major resections, to investigate the surgical treatment of patients and examine the variation in this key cancer treatment depending on their route to diagnosis.

The report covers analyses of data for 20 different cancer sites  and enriches our understanding of the issues associated with access to potentially curative surgery and will hopefully inform efforts to improve referral practices and access to specialist care.

 

Short report: Major resections by cancer site, in England; 2006-2010 (Version 2.0 - reissued June 2015)

Workbook: Major resections by cancer site, in England; 2006 to 2010

This short report examines the variations in major resection rates, in England, broken down by sex and age-groups. Experts believe that surgery is responsible for around half of the cases where cancer is cured, making it the most effective form of treatment. This release builds on prior major resections reports, expanding them by analysing a wider range of cancer sites. It should, though, be noted that the percentages are not comparable with the previous major resections report as a different methodology was used. A more detailed full report on major resections broken down by routes to diagnosis is planned for Spring 2015.

Cancer by deprivation in England 1996-2011: This report examines the most recently available cancer incidence and mortality in England, with the population split into five quintiles using the income domain of the English Indices of Deprivation. Many factors impact on the likelihood of developing cancer, these include being a non-smoker, consuming less alcohol, being of a healthy weight, and eating healthily.  These factors are hard to measure at a population level, but are known to vary with socio-economic deprivation.

Routes to Diagnosis: Comparing multiple studies: Headline figures for the overall proportion of emergency presentations for cancer differ between the two largest studies conducted: 13% and 24%. However, we show that this difference is not necessarily a true one but reflects differences in classifications and methods of counting. Data collected in primary and secondary care have strengths and weaknesses that reflect their source.

Breakdown of incidence and mortality for all malignancies combined by socio-economic deprivation: An extract of our forthcoming publication on cancer incidence and mortality by deprivation appears in Improving Outcomes: A Strategy for Cancer - Third Annual Report 2013.

Further Information

For further information on the partnership work and principles please see the documents below or contact the NCRAS Analytical Programme Manager Luke Hounsome.

For further information on CRUK in general visit the CRUK website or for analytical related queries contact the CRUK Statistical Information Team at: stats.team@cancer.org.uk