Aims Cancer stage at diagnosis is an important prognostic indicator and should be recorded in clinical records and multidisciplinary team meeting (MDM) software. Yet, cancer registrations submitted to the Victorian Cancer Registry (VCR) demonstrate this information is infrequently reported, despite being a mandated field. We sought to quantify (i) the level of compliance of cancer stage data submitted by Health Information Managers (HIM) and clinical coders and understand barriers to complying with this requirement, (ii) how well stage data was recorded in MDM software and barriers to recording.
Methodology Cancer registrations for 2021 and 2022 calendar years for melanoma, colorectal, prostate, breast, and lung cancer were analysed for compliance (complete and submitted in correct fields). Surveys were constructed in Qualtrics and distributed electronically to a HIM distribution list and to the Chairs of the five tumour MDMs in public hospitals.
Results Compliance in reporting cancer stage was highest for lung cancer (11%) and lowest for prostate cancer (7%). Main barriers to registering cancer stage at diagnosis for HIMs and clinical coders (n=156) were staging data not being available for the cancer registration (87% agree), being worried about incorrectly reporting stage and not feeling confident (46% and 42% agree respectively). For MDM leads (n=22), the most significant barriers were time restrictions to capture stage (50% agree) and information not being available at the time of the MDM (50% agree).
Conclusion Increased compliance with legislated staging responsibility will require review of current data sources available and the timing of medical record processing to maximise the data available to clinical coders. Training is likely to increase compliance. MDM structure and processes should be examined to identify improved approaches ensuring data available at the time of the MDM is appropriately recorded as cancer stage.