Connecting in cancer

The recently published Cancer Reform Strategy, which sets the direction of cancer care for the next five years, has emphasised the importance of accurate and timely cancer statistics information to plan and evaluate cancer care and prevention activity, building a world-class cancer service for NHS patients in England.

Cancer registries for many years have been the source of high quality information on incidence, mortality and survival in cancer. A recent collaborative initiative between cancer registries and Public Health Observatories in the North East of England has led to the development of a new publicly accessible interactive web-based tool called the Cancer E-Atlas.

Cancer E-Atlas is a development in the cancer health intelligence arena aiming to promote awareness and access to basic cancer statistics for the main cancer sites affecting men and women. This is the first time that cancer statistics have been published in such an accessible form for the public and patients as well as commissioners, providers, and non-executives across the NHS.

The project has involved three regional PHOs; Yorkshire and Humber, North East and East Midlands, and two cancer registries; Northern and Yorkshire Cancer Registry and Information Service and Trent Cancer Registry. Data at local authority level from both registries have been used to create the Cancer E-Atlas, which can be seen at www.yhpho.org.uk/cancere-atlas.aspx

The data have been extracted from the national Cancer Information Service which is a more detailed analytical tool accessible via NHSnet to NHS users through a registration login process.

Instant Atlas software then provides the platform to view the data in an intuitive front end. Individual local authority areas can be highlighted for the common cancer sites (both incidence and mortality) and then compared to regional, cancer network and other local authority peer areas. Trends in cancer rates can also be seen over the last ten years. Data can be filtered, for example when the viewer wants only to look at and compare local authority spearhead areas.

Figure 1 takes the example of prostate cancer and shows how even neighbouring local authority areas can have markedly different trends in diagnosis rates – in this case likely to be as a result of differing polices on the promotion of Prostate Specific Antigen testing in health communities.

For the more adventurous there is a double map option that allows you to look at the association between two different cancer sites, difference in sex or how mortality changes with increases in incidence. For instance, figure 2 looks at comparing incidence rates against mortality rates in prostate cancer. High incidence rates (horizontal axis in the box at bottom left of the picture) do not always lead to high mortality rates (vertical axis).

The end results can be printed or exported into reports as needed.

Plans are in place to develop this tool to cover all local authorities in England and also develop a sister version with data presented at cancer network level including survival statistics.

This national version will be ready by June 2008 to coincide with the launch of the new National Cancer Intelligence Network. NCIN is a key part of the Cancer Reform Strategy’s drive to improve cancer intelligence across the country and is being developed jointly by the National Cancer Research Institute and the Department of Health for England.

NCIN aims to bring together patient–level datasets and the expertise needed to provide high quality national cancer intelligence. For the first time, data from cancer registries across the country will be brought together with other NHS data about cancer patients to form a single national dataset, providing tools to improve cancer services, increase patient choice and provide a valuable research resource.

The national roll out of Cancer E-Atlas has been funded by NCIN and is one example of the kind of cancer intelligence tools that can be developed to support world class commissioning across the NHS in cancer care and prevention.

Dr Colin Pollock is medical director at the Yorkshire and Humber Public Health Observatory and medical director for the Northern and Yorkshire Cancer Registry and Information Service.