Case-mix adjusted percentage of cancers diagnosed at stages 1 and 2 in England, 2019

Some cancer sites are excluded from the indicator due to higher levels of missing stage at diagnosis data. They were excluded on the basis that their inclusion would compromise the statistical robustness of the measure.

The grouping of stages 1 and 2 in the numerator is intended to be an indication of the proportion diagnosed at an earlier stage when there might be more effective treatment options, improved quality of life, and increased survival following diagnosis. However, treatment decisions and responses, and other factors, will influence outcomes, not just stage at diagnosis alone.

The definition of cancer sites included within this publication has been updated from previous definitions. For this reason, we are publishing a back-series for diagnoses from 2013 onwards. As a result, the crude percentages presented in the workbook are not directly comparable to previous publications (pre 2018 data) related to the ‘percentage of cases of cancer diagnosed at stages 1 and 2’ indicator.

The case-mix adjusted ‘percentage of cancer diagnosed at stages 1 and 2’ indicator makes adjustments for the following patient-level characteristics: age, sex, cancer site and area-level deprivation as defined by the Index of Multiple Deprivation.

The case-mix adjusted values of the ‘percentage of cancers diagnosed at stages 1 and 2’ are applied to the characteristics of the baseline population. This is to enable comparisons of changes to ‘percentage of cancers diagnosed at stages 1 and 2’ indicator which are unrelated to changes to the underlying patient characteristics over time.

Definition of cancer stage is agreed internationally by professional bodies. Although not anticipated, major changes to definitions could undermine meaningful comparisons over time.

The smaller populations when analysing at a Clinical Commissioning Group level create wider confidence intervals. The reliability measure accompanying the output provides an indication of the robustness of the value.

Improvement in recording of stage continues to be part of the work programme for the National Cancer Registration and Analysis Service.