Oral Presentation Victorian Integrated Cancer Service Conference 2015

Determining completeness of case ascertainment to a lung cancer registry: A quantitative case finding audit at two Victorian metropolitan healthcare institutions (#68)

Rob Stirling 1 2 , Peta McLaughlin 2 , Meera Senthuren 2 , Sue Evans 2 , Lise Hales 3 , Annie Gilbert 3 , Chris Bain 3 , Sara McLaughlin-Barrett 4 , Mark Molloy 4 , Helen Farrugia 5
  1. Department of Allergy, Immunology and Respiratory Medicine , Alfred Health , Melbourne , Victoria, Australia
  2. Department of Epidemiology and Preventive Medicine, Monash University, Prahran, VIC, Australia
  3. Alfred Health , Melbourne
  4. Epworth Health, Melbourne, Vic , Australia
  5. Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Vic

Background
The Victorian Lung Cancer Registry (VLCR) pilot project aims to recruit all lung cancer cases diagnosed across participating Victorian sites. Case ascertainment derives from institutional ICD-10 coding. A quantitative, case finding audit was employed to evaluate the case ascertainment methodology and assess capture completeness at a Victorian public and private metropolitan hospital.

Methods
Lists of lung cancer patients recorded for the period 01/07/2011 and 30/06/2012 were requested from institutional departments including; Radiotherapy, Palliative Care, Day Procedure Unit, Oncology Lung Multidisciplinary Team Meeting (MDM), Cardiothoracic Surgery (CTS), Pathology and the Victorian Cancer Registry (VCR). Comparisons were made between VLCR administrative capture versus clinical capture achieved by the use of clinical databases compared with mandated VCR capture.

Results
The VLCR registered 125 new cases in Site A and 100 in Site B. A total of 10 (7.5%) patients in Site A and 13 (11%) patients in Site B had not been recruited by the registry. Investigations indicated that the underreporting of these cases was attributed to:

  • Use of the ICD10 R91 Code (when lung cancer is suspected but not confirmed)

  • Non coded patients (e.g. day admissions, direct admission to palliative care or MDM)

    Conclusion
    The completeness of capture of incident cancers occurring in a population and included in a registry database is a vital attribute of a cancer registry. Current capture is approximately 90% and inclusion of the R code and an attempt to capture un-coded patients will ensure registry incidence rates are close to their true value.