CanStaging+: an electronic staging tool for population-based cancer registries.

Abstract

Cancer staging—the anatomical extent to which a cancer has spread at diagnosis—is crucial in guiding the clinical care of individual patients. At the population level, staging provides useful information on health system performance relevant to a broad range of cancer control activities, including evaluation and monitoring of the impact of health campaigns, screening programmes, and cancer management. The collection of population-based staging data is undertaken by population-based cancer registries (PBCRs), which assign stage at diagnosis for each of the residents of the catchment population based on data from multiple clinical sources using internationally agreed rules. This exercise, however, remains fraught with challenges, with many PBCRs unable to easily report important stage parameters. From the completed questionnaires of Cancer Incidence in Five Continents, volume XI, 347 (75%) of 465 registries reported having collected cancer staging information for diagnoses registered from 2008 to 2012. The proportion varied greatly by cancer site and geographical region, with 96% of registries in North America and Europe reporting the collecting of staging information compared with only 52% in Latin America and the Caribbean. The comparability of staging across populations is also hampered by missing or poorly documented information in clinical systems, or a lack of consistency in the staging systems used by PBCRs. Even in high-income countries, staging data collection and completeness vary—for example, between 2010 and 2014, around 6–37% of staging data were missing for colorectal cancer in PBCRs across seven countries within the International Cancer Benchmarking Partnership. Development of paediatric non-stage prognosticator guidelines for population-based cancer registries and updates to the 2014 Toronto Paediatric Cancer Stage GuidelinesPopulation-based cancer registries (PBCRs) generate measures of cancer incidence and survival that are essential for cancer surveillance, research, and cancer control strategies. In 2014, the Toronto Paediatric Cancer Stage Guidelines were developed to standardise how PBCRs collect data on the stage at diagnosis for childhood cancer cases. These guidelines have been implemented in multiple jurisdictions worldwide to facilitate international comparative studies of incidence and outcome. Robust stratification by risk also requires data on key non-stage prognosticators (NSPs). Full-Text PDF