30-day mortality post-Systemic Anti-Cancer Therapy - Case-Mix Adjusted Rates

The 30-day mortality post-SACT CMAR report includes patients diagnosed with cancer in England and treated with SACT, with each report focusing on a defined cancer type and treatment period.

The latest reports consider:

• patients diagnosed with bowel cancer who received SACT treatment between 2021 and 2022
• patients diagnosed with head and neck cancer who received SACT treatment between 2019 and 2022

Reports to date have covered:

• patients diagnosed with prostate cancer who received SACT treatment between 2020 and 2022
• patients diagnosed with renal cell carcinoma who received SACT treatment between 2019 and 2022
• patients diagnosed with breast cancer who received SACT treatment in 2021

The CMAR reports show rates of deaths within 30 days of SACT treatment, both unadjusted (observed) and adjusted for key patient factors. Overall 30-day mortality rates are presented for each NHS trust identified as treating patients diagnosed with the defined cancer type with SACT within the defined treatment period. Overall rates are supplemented with rates broken down by age group, gender (where appropriate), deprivation quintile, ethnicity group, and intent of treatment.

The analysis presented uses routine data reported by NHS trusts in England through their monthly routine SACT data uploads.

Acknowledgement

This work uses data that has been provided by patients and collected by the NHS as part of their care and support. The data are collated, maintained and quality assured by the National Disease Registration Service, which is part of NHS England.

Each trust will treat a wide variety of patients depending on the population they serve and the services they provide. Thus, case-mix adjusted 30-day mortality rates have been produced which take into account (where these variables are appropriate and available) differences in the age, gender, deprivation quintile, ethnicity, performance status, and co-morbidity score of patients within each trust. As a result, the case-mix adjusted rates are based on an average group of patients as opposed to the trust’s own group of patients.

Case-mix adjusted 30-day mortality rates can be compared between trusts and within trusts over time. This aims to support clinical governance and help NHS trusts identify areas where clinical governance could be improved.

The SACT data set is a population-based resource of SACT activity reported routinely by NHS trusts in England. Data are collected on the SACT treatments of adult and paediatric patients, delivered in secondary and tertiary settings with the intention of improving survival, delaying further cancer progression or development, and improving disease-free or progression-free survival.

For more information on the SACT data set, please see the 'Data Resource Profile on the Oxford Academic' website.

Some NHS trusts have been excluded due to data quality issues, such as less than 70% completeness for patient 'Performance Status'.

Find out more about the SACT data set.

The 30-day mortality post-SACT CMAR work was first released in June 2020 on a quarterly release schedule. In February 2022, the SACT analysis team decided to pause the planned 30-day mortality post-SACT CMAR release schedule in order to perform an evaluation of the work to date and to seek and address user feedback. Thus, with this new report come several changes covering the methodology used, the metrics included, and the presentation method. For full details on the changes made, and for support in using and interpreting the report, please see the report documentation available to download via the dashboard.

All releases prior to this report, which use the historic methodology, can be reviewed on the CancerData website.

Following the release of the latest CMAR reports on 12 December 2024, we will be taking some time to review the CMAR output and will not issue new releases until that review has concluded. We will provide a further update in due course but please contact the Helpdesk in the meantime if you have any questions or feedback we can consider as part of the review. Details of how to provide feedback or seek support can be found below.

The tool is produced by the National Disease Registration Service (NDRS). Please send any feedback or queries to [email protected]

Please do not include sensitive or patient identifiable information.