Audit of prostate cancer: validity and feasibility of registry-based staging

The sample consisted of 251 prostate cancer patients who were newly registered during 1994 from a Regional Cancer Registry. possible for 96% of cases to be staged by Registry clerical staff, but none had been formally staged by clinicians. In 45% of cases tumour extent was based only on Digital Rectal Examination (DRE), and on 32% there was no assessment found. 81% had no investigation of nodal status and 16% of cases had echography other than trans-rectal ultrasound. To find metastases 18% had scintigraphy and 13% had a plain chest X Ray while 61% had no investigation. gression gave age-adjusted hazard ratios relative to stage A (95% CI) of 2.94 (1.59 to 5.44) for Stage B, 6.43 (3.37 to 12.24) for Stage C, and 9.03 (5.12 to 15.95) for stage D. ssons were:• ry clerical staff can abstract stage-related information from a high proportion of case-notes even if stage is not explicitly recorded by clinicians; lidity of registry based staging information is supported by survival analysis; ctivity has resource implications and would be more appropriately performed by a member of the clinical team. s are referred to the companion paper by the authors of this paper, P Silcocks, P Needham, F Hemsley, titled Audit of prostate cancer: lessons learnt for current clinical practice, surrogates for quality of care and standardisation and quality assurance, which covers the clinical/technical aspects and is published in Public Health 1999 113 161–164. (This issue).