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Quality data informs decision making

staging diagram

“The stage or extent of a patient’s cancer at the time of diagnosis is a huge predictor of patient outcome,” says Dr. Louise Parker, Cancer Care Nova Scotia’s (CCNS) Director of Cancer Research. “The more we learn about staging, the more we can focus our efforts on diagnosing cancer earlier when the chances of survival are greatest.”

Stage data is another piece in the information puzzle to understand cancer better today to improve how we prevent, treat and cure cancer tomorrow. This is the reason that CCNS’s Surveillance and Epidemiology Unit, which operates the Nova Scotia Cancer Registry (NSCR), has been working with partners for several years to collect this important information. Today, the processes are in place to enable collection of this data.

The value of stage data in defining the most appropriate treatment plan for patients has always been understood by physicians. For many years, doctors have determined the stage of a patient’s cancer based on the results of various diagnostic tests. This has not changed. What has changed is that Nova Scotia can now add this information to its cancer registry. This additional data helps complete our understanding of the disease. It will be beneficial in studying questions related to managing cancer on a population basis.

Staging can also help assess other important parts of the cancer system, such as the success of screening programs. “Ideally, with a screening program, we would expect, over time, to see more patients being diagnosed at an earlier stage when their chance of cure is highest,” explains Ms. Maureen MacIntyre, Director of CCNS’s Surveillance and Epidemiology Unit.

Cancer Care Nova Scotia’s efforts are part of a national program to eFig. 1xpand data collection to include such critical information as staging. In 2004, the Canadian Council of Cancer Registries established the standards for how stage data would be collected across the country. In Nova Scotia, we began collecting this data for the four most commonly diagnosed cancers: breast, lung, prostate, and colorectal. Currently, the NSCR has stage data for these cancers for the years 2004-2008. As of 2010, stage is being collected for all cancers.

Fig. 3“This has been a huge – and important – undertaking,” says Ms. MacIntyre. “Changes to the registry database as well as significant staff training were required to support the collection of stage data. In this province, stage data is collected manually. This is a very labour intensive process and we’re exploring opportunities to collect data electronically in the future.”

Fig. 4The Nova Scotia Cancer Registry was established in 1964 to capture information about the disease, its diagnosis and treatment, as well as demographic information.

Nova Scotia also is part of a national cancer registry program that enables comparison of data. “This provides us with the big picture,” says Dr. Parker, who is also the principal investigator for the Atlantic Path, the largest cancer study ever conducted in Atlantic Canada.

“In Nova Scotia,” she adds, “we are now developing the ability to map cancer across the province and how it relates to factors in the built environment, the natural environment and our communities.”Fig. 5

The information provided by the registry helps health professionals and government make informed decisions about health resources. It also provides researchers with data to help answer important questions about cancer in our province. Both require strong evidence, and that evidence takes time to collect and analyze.

There is no doubt that by enhancing the cancer information we collect and analyze for the Nova Scotia Cancer Registry today, we will have a greater understanding of cancer tomorrow.

Please note: Data in the cancer registry, including stage data, is confidential. All activities, from the initial registration of a new cancer case through to research and reporting are governed by strict guidelines for data access and reporting.


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