Aim: To assess the feasibility of measurement of Quality Indicators (QIs) for the treatment of cervical cancer at a population level in NSW
Methods: Published QIs on management of cervical cancer were identified through a literature search; QIs on screening, diagnosis or quality of life were excluded. Identified QIs were assessed for feasibility of measurement based on the availability of routine patient data in cancer registries.
The NSW Clinical Cancer Registry (NSW ClinCR) has data on episodes of care for patients with cervical cancer from 2005-2013 in public hospitals across NSW. The NSW ClinCR treatment data were linked to selected variables from the NSW Cancer Registry (NSWCR), NSW Admitted Patient Data Collection (APDC) and the NSW Registry of Births, deaths and Marriages (RBDM) by the Centre for Health Record Linkage (CHeReL). All data were de-identified prior to analysis.
Results: We identified 86 QIs for the treatment of cervical cancer published between 2016-2023, classified as structural (N=11), process (N=65) and outcome (N=10) QIs. Among the process QIs, the identified QIs focused on radiotherapy (N=36), surgery (N=6), chemoradiotherapy or chemotherapy (N=9) and general/pre-treatment (N=14). 13/86 (15%) QIs were measurable based on the patient data items available from population-based cancer registries. These included 1 surgery, 4 radiotherapy, 2 chemoradiotherapy/ chemotherapy and 6 outcome QIs. However we were able to measure half (4/8) of treatment QIs selected by NHS Scotland1 and 3/3 of the US Commission on Cancer quality measures2.
Conclusion: Only a small proportion of QIs for the treatment of cervical cancer could be measured using population level registry data. Most of the identified process QIs measured technical data items that would be collected and stored at an institutional level but not at population level. The measurement of QIs at the institutional level using more detailed clinical data items should be investigated in order to report on quality of care.