Academic journal article Canadian Journal of Public Health

Concordance on the Recording of Cancer in the Saskatchewan Cancer Agency Registry, Hospital Charts and Death Registrations

Academic journal article Canadian Journal of Public Health

Concordance on the Recording of Cancer in the Saskatchewan Cancer Agency Registry, Hospital Charts and Death Registrations

Article excerpt

ABSTRACT

Accurate and complete registries are an important source of knowledge about cancer. The concordance of the recording of noeplasms in the Saskatchewan cancer registry with that in hospital charts and death registrations was evaluated for 368 patients. The agreement between registry and hospital charts or death registrations was excellent (kappa: 0.93; 95% confidence interval: 0.89, 0.97), with 91.3% of those with cancer having the same neoplasm recorded in their chart or death registration as in the registry. There was only one patient whose hospital chart inidacted cancer who was not in the registry and one apparent major discrepancy relating to the cancer site, which was due to the recording of the primary site in the registry and a secondary in the hospital chart. Although based on a relatively small number of patients, these results suggest a high degree of consistency between cancer registry, hospital charts and death registrations in Saskatchewan.

ABREGE

Bell & Howell Information and Learning: Foreign text omitted

Accurate and complete registries are an important source of information for research studies investigating a variety of issues related to disease occurrence.1 Many countries have established cancer registries and endeavoured to make them as accurate as possible,2 although studies to evaluate completeness of coverage and data accuracy have shown a considerable disparity between registries.3-12 Even if the overall accuracy is good, wide variation may exist in the quality of information from different reporting sources or about individual cancers.

In Saskatchewan, cancer is a reportable disease, with information on cases being collected and maintained by the Saskatchewan Cancer Agency (SCA) in its population-based cancer registry, which is one of the oldest in the world having been started in 1932.13 The principal source of registrations (91% of all cases excluding non-melanoma skin cancers) is pathology reports. A further 3% of the registrations come from death certificates, and the rest are from physician service claims, hospital reports, physician referrals and an interprovincial data exchange. All physician service claims with a cancer disease or procedure code are referred to the SCA for approval before payment and any case not registered is followed up with the appropriate physician to verify the diagnosis. The SCA registry is reported to be one of the most complete in Canada,14 although the evidence is limited to the high rate of microscopically confirmed tumours2 and an analysis of the recording of Wilms' tumour cases.15

Knowledge about the consistency between different data sources within a health care system is important for patient care and research purposes.16,17 In a study of aplastic anemia and agranulocytosis18 conditions that can result from the disease and treatment processes of cancer - information on patients was obtained from the SCA registry, hospital chart abstracts and death registrations and an evaluation of the concordance between these data sources was possible.

METHODS

The Saskatchewan government supplies a wide range of publicly funded health care programs to provincial residents, while the SCA provides cancer therapy.14,19 Each eligible resident is issued with a unique health service number (HSN) that is required to obtain benefit from health care programs (>95% of the population of just over one million are eligible residents; the rest are served by federal programs). The HSN is recorded in the relevant datafile when service is provided and is the key to data linkage. The accuracy of the HSNs is maintained on a daily basis and the reliability of the linkage using the HSN is good. The accuracy and reliability of the Saskatchewan health care datafiles have been found to be acceptable for distinct conditions, but poorly defined diagnoses and those determined from laboratory results should be examined with caution. …

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