Reducing DCO registrations through electronic matching of cancer registry data and routine hospital data

The Thames Cancer Registry (TCR) has registered a high proportion of tumour s from death certificate information only (DCO) registrations. This paper d escribes the results of a study set up to establish whether this proportion could be reduced by linking cancer registrations with routine hospital dat a from the Hospital Episodes Statistics (HES) data set using computerized m atching. A total of 67 752 registrations were identified from the TCR. Matc hes were found in the HES data set for 66%. The proportion of cases retriev ed far each tumour site was: 72% for colorectal cancer; 62% for cancer of t he lung, trachea or bronchus; and 65% for female breast cancer. For all thr ee tumour sites the proportion of matches found for patients registered fro m hospital case notes was higher than the proportion found for patients reg istered as DCOs (P < 0.0001 for all three tumour sites). Among matched DCO cases, 58% had at least one procedure recorded. DCO rates might be reduced by as much as 43% (from 17% of total registrations to less than 10%) for th e three most common cancers if the method of electronic matching outlined h ere was used. Younger age groups, prognosis of tumour site and residence in North Thames region were all positively associated with successful matchin g (P < 0.0001 in all three cases). Many matched DCO cases were found to hav e had more than one admission for cancer. Among ordinary in-patient admissi ons, admissions to patients ratios of 1.5, 1.4 and 1.9 were found for color ectal, lung and breast cancers respectively Of 5190 matched DCOs a procedur e was recorded far 3013 (58%). HES data offer a useful aid to follow-up of case notes on patients identified to the registry by death certificates. Do ubts about the completeness and accuracy of HES data mean case notes must r emain the 'gold standard'. (C) 2000 Cancer Research Campaign.