The purpose of the Cancer (clinical) data set specification (C(C)DSS) is to define data standards for the national collection of clinical cancer data so that data collected is consistent and reliable. Collection of this data set specification is not mandated but it is recommended as best practice if clinical cancer data are to be collected. It will facilitate more consistent data collection while enabling individual treatment centres or health service areas to develop data extraction and collection processes and policies that are appropriate for their service settings.
Mandatory reporting regulations have enabled population-based cancer registries in Australia to collect standard information on all incident cases of cancer apart from non-melanoma skin cancers, from which incidence, mortality and overall survival have been determined and trends monitored. The Cancer (clinical) data set specification provides a framework for the collection of more detailed and comprehensive clinical data such as stage of cancer at diagnosis, other prognostic characteristics, cancer treatment and patient outcomes.
The Cancer (clinical) data set specification will support prospective data collection from the time a person with cancer symptoms is referred or first presents to a hospital or specialist through the entire duration of their illness.
The majority of data items in the Cancer (clinical) data set specification are applicable to most solid tumours while many are also relevant to the haematopoietic malignancies such as leukaemia and lymphoma. Data set specifications for specialist tumour streams are also under development and these will contain supplementary data elements that will capture the special features of specific cancer types.
The definitions used in this data set specification are designed to capture the provision of cancer care on a day-to-day level. They relate to the cancer care pathway and the need to optimise care by correctly diagnosing, evaluating and managing patients with cancer. In addition, end-points and patterns of care can be monitored to understand both the appropriateness and effectiveness of cancer care.
The data elements specified provide a framework for:
- promoting the delivery of evidence-based care to patients with cancer
- facilitating the ongoing improvement in the quality and safety of cancer management in treatment settings
- improving the epidemiological and public health understanding of cancer
- informing treatment guidelines and professional education
- guiding resource planning and the evaluation of cancer control activities
They will facilitate the aggregation of data across different treatment centres.
The underlying long-term goal is to provide data support to improve outcomes for patients by increasing the quality and length of life. For example, a comparison of the actual management of patients with best practice guidelines may identify shortfalls in treatment and limitations in access to treatment modalities for some patients.
The working group formed under the stewardship of Cancer Australia was diverse and included representation from the following organisations: Cancer Australia, University of Sydney-Department of Gynaecological Oncology, Westmead Institute for Cancer Research, Cancer Council Victoria, Royal Brisbane & Women’s Hospital, National Breast and Ovarian Cancer Centre, The Royal Women's Hospital, Queensland Health, Ministry of Health, NSW Health, TROG Cancer Research, and the Cancer Institute NSW.
To ensure the broad acceptance of the data set specification, the proposed list of data items was circulated to members of Cancer Australia’s National Cancer Data Strategy Advisory Group, a multidisciplinary group with a broad spectrum of epidemiological knowledge and expertise, and the inter-governmental Strategic Forum, comprising clinicians and senior health department officials from the Australian Government and from each state and territory government, and with strong community representation. The working group also sought consultation from cancer registry data managers, clinical leaders, pathologists, medical oncologists and radiation oncologists to achieve consensus when required.
Metadata items in this Data Set Specification
Below is a list of all the components within this Dataset Specification.
Each entry includes the item name, whether the item is optional, mandatory or conditional and the maximum times the item can occur in a dataset.
If the items must occur in a particular order in the dataset, the sequence number is included before the item name.
|0 Cancer staging—cancer staging scheme source edition number, code N[N]||
|1 Cancer staging—cancer staging scheme source, code N[N]||
|2 Cancer staging—staging basis of cancer, code A||
|3 Cancer treatment—cancer treatment type, code N[N]||
Cancer treatment—other cancer treatment, text [X(150)]
Conditional Obligation:Conditional on the patient having treatment that cannot be defined as surgery, radiotherapy or systemic therapy according to the definitions of those data items in this data set specification.
|5 Cancer treatment—outcome of treatment, code N.N||
|6 Date—accuracy indicator, code AAA||
|7 Establishment—organisation identifier (state/territory), NNNNN||
|8 Healthcare provider—organisation identifier, N(16)||
|9 Patient—cancer status, code N||
|11 Patient—diagnosis date of cancer, DDMMYYYY||
|14 Person (address)—address line, text X[X(179)]||
|15 Person (name)—family name, text X[X(39)]||
|16 Person (name)—given name, text X[X(39)]||
|19 Person with cancer—extent of primary cancer, TNM stage (UICC TNM Classification of Malignant Tumours, 7th ed) code X[XX]||
|22 Person with cancer—morphology of cancer, code (ICD-O-3) NNNN/N||
|27 Person with cancer—primary site of cancer, topography code (ICD-O-3) ANN.N||
|33 Person—date of birth, DDMMYYYY||
Person—date of death, DDMMYYYY
Specific Information: This field must be greater than or equal to Date of diagnosis of primary cancer.
Conditional Obligation:Recorded when the patient has died.
|35 Person—government funding identifier, Medicare card number N(11)||
|36 Person—Indigenous status, code N||
|37 Person—person identifier, XXXXXX[X(14)]||
|38 Person—sex, code N||
Person—underlying cause of death, code (ICD-10 2nd edn) ANN-ANN
Recorded when the patient has died.
Guide for use:
The Cancer (clinical) data set specification contains six data clusters relating to cancer treatment. To ensure a complete description of the clinical management of cancer, it is recommended that if the patient has had the specific treatment modality the cluster refers to, each data item within the cluster should be completed.
The data clusters are as follows:
- Chemotherapy for cancer cluster
- Hormone therapy for cancer cluster
- Immunotherapy for cancer cluster
- Radiotherapy for cancer cluster
- Surgery for cancer cluster
- Systemic therapy procedure for cancer cluster