This section outlines the work being undertaken to enhance the information being collected in the registry.
In 2011, Cancer Control New Zealand and the Ministry of Health announced that the NZCR would be expanded to capture a wider set of information (known as clinical TNM data) on the extent of solid tumours.
It was also agreed to collect pathological data in a nationally consistent structured format, in line with the tumour protocols being developed by the Royal College of Pathologists of Australasia (RCPA). A project was established to implement these changes.
Clinical TNM (cTNM)
Clinical staging information will enable calculation of the survival of cohorts of patients in relation to the extent of their malignant disease at time of diagnosis, and the ability to measure the effectiveness of screening programmes and different treatment regimes. Survival analysis will also facilitate international benchmarking to identify how well New Zealand is doing in comparison to other countries.
An IT tool to aid the collection of cTNM data was developed and trialled in March 2013.
The trial established that the IT tool is user friendly but more work needed to be done on the business processes around how best to capture the data from clinicians.
A focussed pilot project has been set up at Counties Manukau DHB to look at the collection of cTNM at Colorectal Cancer Multi-Disciplinary Meetings (MDMs) using the IT tool that has been developed.
The pilot will consider the potential to collect and record a provisional cTNM and to have a requirement to note a final cTNM at the MDM at which a treatment plan is agreed.
Data definitions will be consistent with the TNM handbook and the National Cancer Core Data Standards.
The development of structured reports for pathology reporting
Nationally consistent structured (or synoptic) reporting, based on cancer reporting protocols developed by the Royal College of Pathologists of Australasia (RCPA), provides significant efficiencies for clinicians and organisations through the ease and completeness of data capture and interpretation, irrespective of where in the country, or for which organisation, a clinician works.
The NZCR structured reporting tool is a web-based interface that allows pathologists to complete a template and then copy the resulting report into their Laboratory Information System (LIS).
To meet Department of Internal Affairs security requirements the NZCR tool is designed for browsers such as Firefox, Chrome, Safari and Internet Explorer version 8 and above.
Where a laboratory already has a structured report that matches the requirements of the RCPA protocols there is no requirement for that laboratory to use the new NZCR structured report tool.
The first structured report was made available from October 2013 and was based on the RCPA colorectal cancer protocol.
The prostate cancer (radical prostatectomy) structured report went live on 6 December 2013 followed by the structured reports for lung cancer and breast cancer on 21 March 2014 – the breast cancer structured report being the most complicated of them all.
The Prostate (core biopsy) structured report has just gone live 20 June 2014. Structured reports for other cancer sites may be developed in the future.