1 Cancer in South East England 2005 report

The Thames Cancer Registry's annual report, published in December 2007, describes the 2005 cancer statistics for the 12 million population of London, Kent, Surrey and Sussex. Included are the summary statistics for incidence, treatment and survival aggregated by cancer network, different aspects of the patient pathway including treatment, flows across cancer networks and place of death. A revised presentation of cancer network survival figures makes comparison between the different areas easier.

We have previously reported cancer projections for England, developed for the Cancer Reform Strategy, in collaboration with colleagues from the Northern and Yorkshire Cancer Registration and Information Service (NYCRIS), Norway and the Department of Health. These analyses show that the number of cancer patients in England will increase by one third by 2020 - a fact that has significant implications for planning cancer services. In this year's report we set out some further longer term projections of age-standardised rates in different generations.

2 The Cancer Reform Strategy

The Vision: The Cancer Reform Strategy, published in December 2007, sets out a vision and a detailed plan for preventing cancer, ensuring its early diagnosis and treatment, and improving clinical outcomes and care for patients by 2012. Particularly relevant to the work of cancer registries is an ambitious programme to bring all cancer data together in one place, and to use this more effectively to monitor policies, improve clinical outcomes and quality of care, support informed choice for patients, stronger commissioning of services, and to develop cancer research. Better use of existing cancer information will be achieved by the National Cancer Intelligence Network (NCIN), a new collaboration between the regional registries, other organisations, clinicians, patients, researchers, policy makers, decision-makers and other stakeholders. There will also be new information collected regularly on public awareness of cancer and patients' experiences of services and this will all be used for an annual report of progress by the National Clinical Director for Cancer.

Practical steps: One initial task for the NCIN will be to produce large quality-assured national datasets, joining together the existing cancer registry, hospital episode statistics (HES), waiting times, radiotherapy and chemotherapy treatment data. Another is the development of a commissioning toolkit which will supply strategic health authorities, specialist commissioning groups, cancer networks, PCTs, and NHS Trusts with comparative data on cancer incidence, survival and mortality together with information from hospital episodes statistics. As part of the development of the NCIN, individual registries will take on a lead role for specific cancer sites. The Thames Cancer Registry (TCR) has undertaken the analysis for the National Lung Cancer Audit for three years, and we will take the lead registry role for lung and upper gastrointestinal cancers.

Improving data collection: There is an urgent need to improve the completeness of data received by registries on staging, histopathology, cytopathology, and ethnicity as well as more detailed information on radiotherapy and chemotherapy regimes. Multidisciplinary teams (MDTs) and primary care trusts will have an important role in making this information available to cancer registries and to national clinical audits. It is expected that by 2009 trusts should be providing registries with this data in electronic format. TCR has been liaising with the suppliers of the pathology databases to make this task easier for hospital trusts. We are now receiving electronic pathology data from 38 of 45 trusts. The Registry has also been significantly involved in the development of the PRAXIS computer system now being implemented in a number of UK registries, which allows the capture of large amounts of electronic data and its linkage. We will be working with cancer networks and individual hospital and primary trusts, where necessary, to improve the capture of this data.

3 Cancer Inequalities in London

The launch of Cancer Inequalities in London 2000-2004 by TCR in October 2007 was followed by significant interest within London, and some of its findings were covered by The Evening Standard and Nature Network Forum and other local media. Tackling inequalities is one aim of the Cancer Reform Strategy and we hope this report will stimulate debate and serve as a baseline for policy makers, commissioners, clinicians and other decision-makers seeking to understand their local populations and decide on priorities for action. We have embarked on new collaborative projects with these colleagues.

4 Linking Cancer Registry and Hospital Episode Statistics (HES) data

This year the TCR applied for and received a national extract of HES data from the Information Centre for Health and Social Care on behalf of eight regional English registries, two regional childhood cancer registries and the Childhood Cancer Research Group. The Registry is now working jointly with NYCRIS and other registries to link the extract to the national cancer registry data. Outputs of our linkage work have been the publication of work on the incidence of cancer of the testis and prostate in different ethnic groups in South East England, ongoing work on breast cancer and the linkage of HES and registry data to the National Oesophago-Gastric Cancer Audit dataset.

Thames Cancer Registry is a Department in the Division of Cancer Studies in King's College London School of Medicine. For general comments and inquiries about the registry, see our web site http://www.tcr.org.uk, email tcr@kcl.ac.uk or telephone 020 7378 7688.

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