From theory to practice: Implementation of the Toronto consensus principles and guidelines for the recording of paediatric cancer stage

Abstract

Background/Objectives: Access to consistent, population-wide data on cancer stage is essential for meaningful international comparisons of incidence and outcomes. The recently endorsed Toronto Consensus Principles and Guidelines for the collection of cancer stage by population registries are yet to be tested in practice. Our objective was to evaluate the feasibility of collecting data on stage at diagnosis for a wide range of childhood cancers within a population-based cancer registry (the Australian Paediatric Cancer Registry). This work was supported as part of a national initiative by Cancer Australia to improve cancer staging data for all Australian patients. Design/Methods: Business Rules were developed for 16 diagnostic subgroups, in line with the Toronto Consensus Principles and Guidelines, for both low (Tier 1) and high (Tier 2) resource settings. A sample of 1438 cases diagnosed during the period 2006-2010 was selected at random from seven hospitals located across all six Australian states. The proportion of cases that could be staged by a clinical coder using the Business Rules and based only on information available in medical records was assessed. Information required for staging that was missing from the medical record was noted, when this occurred. Results: Results to date indicate that stage at diagnosis can be assigned for the majority of cases using the detailed Tier 2 criteria. Of 277 cases assessed thus far, over 90% had sufficient information in the medical record to allow stage (as per the Toronto Guidelines) to be assigned by a clinical coder. Stage could be assigned for over 95% of children diagnosed with osteosarcoma, hepatoblastoma, medulloblastoma or Ewing sarcoma. Conclusion: The Toronto Consensus Principles and Guidelines provide the first comprehensive and useable framework for population cancer registries to collect uniform information on stage at diagnosis for most childhood cancers.L6125929502016-11-11 <br />