1. South West Public Health Observatory South West Regional Public Health Group Overview of Neuro-oncology in the South West Sean McPhail South West Public Health Observatory sean.mcphail@swpho.nhs.uk

2. South West Public Health Observatory South West Regional Public Health Group Introduction Changes in SWCIS audit function Overview of Neuro-oncological cancer in the SW Examples of type of work that is possible Recent work on combining datasets

3. South West Public Health Observatory South West Regional Public Health Group Electronic data sources Cancer Registry databases ONS Mortality Hospital Episode Statistics (HES) data Cancer Waiting Time data RES Radiotherapy data Electronically submitted pathology reports

4. South West Public Health Observatory South West Regional Public Health Group Types of analysis By Trust, Network, or defined group of patients: Numbers, rates, age-standardised rates Crude and relative survival Geographic Information Systems (GIS) Patient follow-up Histopathology and grade

5. South West Public Health Observatory South West Regional Public Health Group Malignant brain cancer incidence trends

6. South West Public Health Observatory South West Regional Public Health Group Rate of New diagnoses by ageband in South West

7. South West Public Health Observatory South West Regional Public Health Group Population change in the SW Source: ONS 1981 1991 2001 2011 (estimated) Net regional flow per year Census population by age (thousands) 0 100 200 300 400 0 100 200 300 400 0 100 200 300 400 0 100 200 300 400 00-0405-0910-1415-1920-2425-2930-3435-39 40-4445-4950-5455-5960-64 65-6970-7475-7980-84 85+ Aging population… …and inflow of older people +10 -10 +14 +11+2

8. South West Public Health Observatory South West Regional Public Health Group Malignant brain cancer incidence up to 2020 Number of cases: Male +19%, Females -4% Age standardised rate per 100 000 people Source: Thames Cancer Registry

9. South West Public Health Observatory South West Regional Public Health Group Malignant brain cancer – mortality trends

10. South West Public Health Observatory South West Regional Public Health Group Death rate by 5-year ageband

11. South West Public Health Observatory South West Regional Public Health Group Malignant Brain cancer – survival in the SW

12. South West Public Health Observatory South West Regional Public Health Group Inter-trust transfers (2004 combined HES and cancer registry data) Count number of referrals between Trusts

13. South West Public Health Observatory South West Regional Public Health Group Analysis by socio-economic deprivation 18 Lung cancer mortality rate 0 20 40 60 80 100 12345 Deprivation quintile (income) Rate per 100,000 More deprivedLess deprived

14. South West Public Health Observatory South West Regional Public Health Group GIS analysis – travel times

15. South West Public Health Observatory South West Regional Public Health Group Patient pathway analysis Patient cohort defined as people as diagnosed with prostate or bladder cancer in 2000 in the SW GOR (as recorded on the SWPHO cancer registry). 2862 Prostate cancer patients 925 Bladder cancer patients

16. South West Public Health Observatory South West Regional Public Health Group Number of episodes leading up to death, prostate and bladder cancer Time in months

17. South West Public Health Observatory South West Regional Public Health Group Number of episodes leading up to death, prostate cancer, by admission type Time in months

18. South West Public Health Observatory South West Regional Public Health Group Bed days leading up to death in prostate and bladder cancer, by care specialty Time in months

19. South West Public Health Observatory South West Regional Public Health Group Bed days leading up to death in prostate and bladder cancer, by care specialty – emergency only Time in months

20. South West Public Health Observatory South West Regional Public Health Group Bed days leading up to death in prostate and bladder cancer, by care specialty – elective only Time in months

21. South West Public Health Observatory South West Regional Public Health Group Summary & conclusions Some analyses / audits can be performed more efficiently with electronic data collection: –Waiting times –Provision of surgery –Patterns of referral Some do require prospective data collection Use of electronic databases allows new types of audit/analysis

22. South West Public Health Observatory South West Regional Public Health Group Thank you sean.mcphail@swpho.nhs.uk