COSD v9.0 and Pathology Downloads

This page contains downloads for the Cancer Outcomes and Services Dataset (COSD) Version 9.0.1 and Pathology V4.0.1

Current documentation for COSD v9.0

Pathology dataset

Following consultation with Laboratory Information Management System (LIMS) Suppliers and the Chair of the Royal College of Pathologists (Working Group on Cancer Services), alterations to the structure or contents of the dataset have been made in the updated versions of the pathology documents below. Details of the changes are in the spreadsheet summary and change log.

COSD Main Dataset


To download either the Main COSD or Pathology schema packs, you first need to create a TRUD account.

How to create a TRUD account

See the NHS Digital XML Schema TRUD Download webpage for further information and to be guided through the process or 

Go straight to the NHS Digital TRUD website:

  • select 'create one now' (directly under 'log in')
  • fill out the online form
  • you will be sent a password
  • log in with your new password. Once logged in you can change your password via 'Manage account' (top right hand of the screen)

How to download a schema pack

Once you have a TRUD account:

  • go to the NHS Digital TRUD website and log in
  • select 'DD XML Schemas' from the 'Downloads' section (far left of the screen)
  • identify the schema pack you want and 'subscribe to this dataset'
  • tick 'I accept the licence' and then 'Request this subscription'
  • you will receive a confirmation email
  • download the required schema pack

Why change to COSD v9.0?

It is important to constantly maintain clinical accuracy and engagement with the MDT teams and to achieve this we needed to review and make some important changes to the dataset. These changes continue to build on the work started in v7.0 and further rolled out through v8.1. They include some new amendments and re-alignments to the current data set, as well as a revision of the current schema specification in order to continue to meet the business objectives of the standard.

The COSD v9.0 amendments were made following extensive consultation over a 9 month period with 40 key groups or 150 clinical experts, including:

    • site specific Expert Advisory Groups (EAGs) within PHE
    • experts from within the National Cancer Registration and Analysis Service (NCRAS)
    • clinical support and advice from the chair of the Royal College of Pathologists Working Group on Cancer Services
    • cancer charities (Cancer Research UK, AMMF - The Cholangiocarcinoma Charity, Breast Cancer Care, Living Beyond Cancer and MacMillan)
    • patient groups and individuals through ‘Use My Data’ and the EAGs
    • national cancer audits
    • cancer and pathology system suppliers
    • NHS England
    • Cancer Waiting Times (CWT)
    • quality surveillance
    • cancer taskforce transformation board

This revision allowed the data sets to be clinically reviewed, validated and updated by experts in all fields of cancer, and provides a clinically sound set of data to be collected from April 2020 onwards.

However, it was recognised that there were still further improvements required within this release to improve data quality and to be more reflective of current and future changes in cancer treatments, outcomes and clinical care.

Mandating key data items was vital in this release to improve data quality and reduce the burden of data processing within NCRAS. If a treatment record for example is submitted without a date or modality, it is of no use as a cancer registration event, however a registration officer would still have to review each incomplete record submitted, this multiplied by thousands of incomplete records per year was an unsustainable practice.

It also provides a clinically sound set of data which meets crucial recommendations in the Achieving World-Class Cancer Outcomes, A Strategy for England 2015-2020 (Cancer Taskforce Report).

In total, 101 new data items (18 pathology specific) were added to meet the changing demands of cancer treatment and outcome data. In addition, there were 80 data items deleted, of which 12 are pathology specific. More importantly, this version has a strong emphasis on improving data quality and ascertainment along with formally separating pathology away from the patient pathway elements of a cancer record.

Many sections in the core now have mandatory elements within them, this will drive up data quality without creating undue burden on either the people collecting the data (within the Trusts) or those processing the data (within NCRAS).

Changes to CancerStats

CancerStats continues to be a vital resource for Trusts. The following reported areas are currently available:

      • Incidence, Survival and Mortality
      • COSD
        • Level 1, 2 and 3
        • Updated staging sheets
        • Submission dates
        • Document library
      • National Audit of Breast Cancer in Older Patients (NABCOP) 
      • National Lung Cancer Audit (NLCA)
      • National Prostate Cancer Audit (NPCA)
      • Clinical Headline Indicators (CHI)
      • New areas to come on Pathology conformance reporting

Help and feedback

Contact your local NCRS office or email COSDenquiries at phe dot link with comments and feedback on the documentation.

We value feedback and suggestions for improvements. All suggestions would be reviewed by the COSD Advisory Board and if accepted would be added to the change process for the next version of COSD.


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