Journal Article

An investigation of routes to cancer diagnosis in 10 international jurisdictions, as part of the International Cancer Benchmarking Partnership: survey development and implementation

Anandan, Chantelle, Turner, Donna, Grunfeld, Eva, Lambe, Mats, Bomb, Martine, Neal, Richard D, Kalsi, Jatinderpal, Zalounina, Alina, Liston, William, White, Victoria, Weller, David, Vedsted, Peter, Jensen, Henry, Law, Rebecca-Jane, Desai, Rakshit, Gavin, Anna, Barisic, Andriana, Menon, Usha, Fourkala, Evangelia Ourania, Malmberg, Martin

2016

Overview

ObjectivesThis paper describes the methods used in the International Cancer Benchmarking Partnership Module 4 Survey (ICBPM4) which examines time intervals and routes to cancer diagnosis in 10 jurisdictions. We present the study design with defining and measuring time intervals, identifying patients with cancer, questionnaire development, data management and analyses.Design and settingRecruitment of participants to the ICBPM4 survey is based on cancer registries in each jurisdiction. Questionnaires draw on previous instruments and have been through a process of cognitive testing and piloting in three jurisdictions followed by standardised translation and adaptation. Data analysis focuses on comparing differences in time intervals and routes to diagnosis in the jurisdictions.ParticipantsOur target is 200 patients with symptomatic breast, lung, colorectal and ovarian cancer in each jurisdiction. Patients are approached directly or via their primary care physician (PCP). Patients’ PCPs and cancer treatment specialists (CTSs) are surveyed, and ‘data rules’ are applied to combine and reconcile conflicting information. Where CTS information is unavailable, audit information is sought from treatment records and databases.Main outcomesReliability testing of the patient questionnaire showed that agreement was complete (κ=1) in four items and substantial (κ=0.8, 95% CI 0.333 to 1) in one item. The identification of eligible patients is sufficient to meet the targets for breast, lung and colorectal cancer. Initial patient and PCP survey response rates from the UK and Sweden are comparable with similar published surveys. Data collection was completed in early 2016 for all cancer types.ConclusionAn international questionnaire-based survey of patients with cancer, PCPs and CTSs has been developed and launched in 10 jurisdictions. ICBPM4 will help to further understand international differences in cancer survival by comparing time intervals and routes to cancer diagnosis.

• Publisher: BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Analysis of Variance / Antineoplastic Combined Chemotherapy Protocols / Australia - epidemiology / Benchmarking / Breast Neoplasms - diagnosis / Breast Neoplasms - epidemiology / Canada - epidemiology / Cancer / Cancer and Oncology / Cancer och onkologi / Clinical Medicine / Colorectal Neoplasms - diagnosis / Colorectal Neoplasms - epidemiology / Comorbidity / Cross-Sectional Studies / Data collection / Denmark - epidemiology / Early Detection of Cancer - standards / Female / Health Services Research / Humans / Jurisdiction / Klinisk medicin / Lung Neoplasms - diagnosis / Lung Neoplasms - epidemiology / Medical and Health Sciences / Medical diagnosis / Medical research / Medical screening / Medicin och hälsovetenskap / Norway - epidemiology / Ovarian Neoplasms - diagnosis / Ovarian Neoplasms - epidemiology / Ovaries / Patients / Pilot Projects / Practice Patterns, Physicians' - organization & administration / Practice Patterns, Physicians' - statistics & numerical data / Primary care / Primary Health Care - standards / Questionnaires / Registries / Reproducibility of Results / Survival Rate / Sweden - epidemiology / United Kingdom - epidemiology