Rapid Fire Best of the Best Oral 2025 Joint Meeting of the COSA ASM and IPOS Congress

The journey to improve capture of cancer stage at diagnosis (126558)

Sue Evans 1 , Luc te Marvelde 1 , Linda Nolte 2 , Kris Ivanova 1 , Fiona Kennett 1 , Kerry Davidson 3 , Belinda Yeo 4 , Carla Read 5 , Kathryn Baxter 6 , Patsy Catterson 7 , Anupa Bhandari 6 , Jodie Lydeker 8
  1. Cancer Council Victoria, Melbourne, VIC, Australia
  2. North Eastern Metropolitan Integrated Cancer Service, Austin Health, Heidelberg
  3. Grampians Integrated Cancer Service (GICS), Ballarat Health Service, Ballarat, Victoria, Australia
  4. Olivia Newton-John Cancer Research Institute, Austin Hospital, Heidelberg, Victoria, Australia
  5. Enterprise Technology Branch (ETB) eHealth Division , Department of Health, Melbourne, Victoria, Australia
  6. Health Information Management, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  7. Health Information Services , Grampians Health, Ballarat, Victoria, Australia
  8. Breast Cancer Network Australia, Cancer Council Victoria, Camberwell, Victoria, Australia

Background:
Stage at diagnosis is a mandatory data item for the Victorian Cancer Registry (VCR) but has historically been poorly reported. To address this, the VCR launched a program to identify barriers, raise awareness, and improve compliance. More recently, the focus shifted to understanding strategies implemented by health services to improve staging documentation.

Methodology:
Compliance reports were sent to hospitals submitting at least 100 cancer registrations annually for the five most common tumour types (prostate, lung, breast, bowel, and melanoma). Reports were issued in August 2023 (baseline: 2021–2022 diagnoses), August 2024 (timepoint 1), and April 2025 (timepoint 2). A survey was distributed with the second and third reports via Qualtrics to Chief Health Information Officers to gather feedback on actions taken.

Results:
Sixty-three hospitals received each report. Among the 20 highest-volume hospitals, compliance improved from 8.6% at baseline to 21.1% by timepoint 2 (median = 8.5%, IQR = 5.8–22.9%). The top-performing hospital achieved 50% overall. Highest tumour-specific compliance by a single hospital reached 81% (lung), 64% (breast), 62% (bowel), and 55% (melanoma). No high-volume hospital exceeded 25% for prostate. Lower-volume hospitals improved from 7.3% to 11.0% (median = 6.8%, IQR = 2.7–16.8%).

Twenty-four hospitals (38%) responded to the final survey. Most had reviewed and shared the reports internally. Reported interventions included staff training, use of checklists, and electronic medical record (EMR) enhancements such as adding stage fields, generating reports, and linking to external databases. Audits highlighted missed documentation. The most significant improvements occurred at hospitals that enabled structured stage abstraction and included stage in discharge summaries.

Conclusion:
Hospitals adopting structured processes—particularly EMR enhancements—showed the greatest improvements in staging data. Broader implementation of these strategies could improve cancer data quality across Victoria.