Analytical Studies: Methods and References
Canadian Cancer Treatment Linkage Project

by Gisèle Carrière, Claudia Sanmartin, Patricia Murison, Richard Trudeau, Cathy Trainor, Caroline Pelletier, Nathan Farrar, Austin Snow, Shirley Bryan, and Kim Newman
Health Analysis Division, Health Statistics Division, Special Surveys Division, and Statistics Canada

Release date: March 27, 2018 Correction date: (if required)

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Acknowledgements

Acknowledgements to Working Group members: Mary Jane King, Cancer Care Ontario; Heather Stuart-Panko, Saskatchewan Cancer Agency; Sheila Fukumura, Cancer Care Manitoba; Kim Vriends, Prince Edward Island Cancer Registry; Maureen MacIntyre, Cancer Care Nova Scotia; Ryan Woods, BC Cancer Agency; Gordon Walsh, Cancer Care Nova Scotia; Greg Webster, Director, Acute and Ambulatory Care Information Services, Canadian Institute for Health Information (CIHI); Janet Manuel CHIM, Classification Specialist, Classifications and Terminologies, CIHI; and Alana Lane CHIM, Classification Specialist, Classifications and Terminologies, CIHI.

Acknowledgements to consulted medical clinicians for providing expert guidance on selection of surgical treatment of the six cancers investigated. Dr. Ralph Gilbert, MD, FRCSC, Head & Neck Surgeon at the University Health Network, provided recommendations for listed surgical interventions to treat thyroid cancer. Dr. Geoffrey Gotto, MD, MPH, FRCSC, Clinical Associate Professor, Department of Surgery, The University of Calgary, provided recommendations for listed surgical interventions to treat urinary bladder cancer. Dr. Christian Finley, MD, FRCSC, Associate Professor in the Department of Surgery Division of Thoracic Surgery, McMaster University, provided recommendations for listed surgical interventions to treat cancer of the lung and bronchus.

Executive summary

Record linkage has been identified as a potential mechanism to add treatment information to the Canadian Cancer Registry (CCR). The purpose of the Canadian Cancer Treatment Linkage Project (CCTLP) pilot is to add surgical treatment data to the CCR. The Discharge Abstract Database (DAD) and the National Ambulatory Care Reporting System (NACRS) were linked to the CCR, and surgical treatment data were extracted. The project was funded through the Cancer Data Development Initiative (CDDI) of the Canadian Partnership Against Cancer (CPAC).

The CCTLP was developed as a feasibility study in which patient records from the CCR would be linked to surgical treatment records in the DAD and NACRS databases, maintained by the Canadian Institute for Health Information. The target cohort to whom surgical treatment data would be linked was patients aged 19 or older registered on the CCR (2010 through 2012) with a primary diagnosis of the following: female breast, colorectal, prostate, thyroid, urinary bladder, or lung cancer. To identify primary surgical treatments for these cancers, code sets were developed for each site using current standards (for example, Canadian Classification of Health Interventions [CCI]). With this linkage, two new core data elements were developed and added to the linked CCR-DAD-NACRS analytical file: Procedure date and Primary procedure.

The linkage was completed in Statistics Canada’s Social Data Linkage Environment (SDLE). Within the SDLE, each file (CCR, DAD, NACRS) was linked to the Derived Record Depository (DRD), a regularly updated repository of personal identifiers for all Canadians. Linkage keys extracted through this process were used to create the linked CCRDADNACRS file, from which the cohort was extracted (records with only one tumour from among the six target cancers coupled with surgical interventions identified in the treatment code set). Linkage rates for the three files were robust, with each having a rate greater than 90% in the years covered.

The CCTLP demonstrated the feasibility of using record linkage to add surgical treatment data to patient records for six cancers. Opportunities for further development were identified, including the need to improve linkage rates to minimize the number of surgical treatments that are lost. In addition, a protocol for assigning one or more surgical treatments to patient records where multiple tumours are present in the same organ, within the follow-up period, will be required. Nevertheless, record linkage has been shown to be an effective means of increasing the analytical value of Canadian cancer data holdings.

1 Introduction

The Canadian Cancer Registry (CCR), established in 1992, is a collaborative undertaking between Statistics Canada and the 13 provincial and territorial cancer registries to create a single database to report annually on cancer incidence and survival at the national and jurisdictional levels (Statistics Canada n.d.b, 2011). The Registry produces high-quality information on cancer events, but lacks information about treatment. The addition of treatment information would enhance the CCR’s surveillance capacity and its analytical capacity for researchers and epidemiologists.

To address this information gap, Statistics Canada, in partnership with the Canadian Council of Cancer Registries (CCCR), undertook a study to determine the feasibility of using record linkage to add treatment information to the CCR for three cancers—breast, prostate and colorectal—in four provinces (Ontario, Manitoba, Nova Scotia, and Prince Edward Island). The study involved linking hospital data (Discharge Abstract Database [DAD] and National Ambulatory Care Reporting System [NACRS]) to the CCR. The results demonstrated the feasibility of using record linkage to add treatment data to the CCR, specifically, surgical treatment data, which are comprehensively reported in the hospital data (Carrière et al. 2015).

The Canadian Cancer Treatment Linkage Project (CCTLP) builds on that work. Using the Social Data Linkage Environment (SDLE) at Statistics Canada, the DAD and the NACRS were linked, and administrative, diagnostic and surgical treatment data were extracted and added to the CCR.

This report provides information on the record linkage process, data validation, and surgical treatment rates for six types of cancer—breast, colorectal, prostate, urinary bladder, thyroid, and lung and bronchus. The project was funded through the Cancer Data Development Initiative (CDDI) of the Canadian Partnership Against Cancer (CPAC n.d.). The linkage was approved by the Statistics Canada Executive Management Board (May 2016) (Statistics Canada n.d.a). Use of the linked data is governed by Statistics Canada’s Directive on Record Linkage (Statistics Canada n.d.c).

2 Data sources

2.1 Canadian Cancer Registry

The Canadian Cancer Registry (CCR) contains information about all cancers diagnosed in Canada, compiled from provincial and territorial cancer registries. It covers all Canadian residents, living and deceased, diagnosed with cancer since 1992, including primary (incident) cancers among patients previously diagnosed with cancer. Every calendar year, the CCR reports confirmed information about each new tumour, including tumour type and date of diagnosis, and demographic data about the patient (Statistics Canada 2008). CCR records from 1992 to 2013 were available for linkage (n = 3,126,295). 

2.2 Discharge Abstract Database

The Discharge Abstract Database (DAD) contains demographic, administrative, and coded diagnostic and intervention data for acute care, some psychiatric, chronic rehabilitation, and selected day surgery hospital discharges (CIHI 2010a, 2011a, 2012b, 2012c, 2013, 2014a, 2015a). These are reported annually by all jurisdictions, excluding Quebec, to the Canadian Institute for Health Information (CIHI) on a fiscal year basis (April 1 to March 31). The DAD registers about 3.7 million discharges per year. DAD discharges occurring between April 1, 1994, and March 31, 2015, were available for linkage (n = 77,925,269).

2.3 National Ambulatory Care Reporting System

The National Ambulatory Care Reporting System (NACRS) contains data about visits to health care facilities for ambulatory care, including community-based services, day surgery procedures, emergency department visits, diagnostic imaging, and selected clinic visits (for example, oncology care) (CIHI 2009b, 2010b, 2011b, 2011c, 2011d, 2012d, 2012e, 2014b, 2015b). At each visit, patient demographics, clinical information (diagnoses, surgical interventions), and administrative, financial and service-specific data are recorded. NACRS data are reported to CIHI on a fiscal year basis (April 1 to March 31).

NACRS data are reported most comprehensively by Ontario; less so for other provinces and territories (CIHI 2010d). Newfoundland and Labrador, and New Brunswick did not report to the NACRS for all years; Quebec does not report to the NACRS. NACRS records for April 1, 2002, through March 31, 2015, were available for linkage (n = 166,069,085).

2.4 Canadian Vital Statistics Database

The Canadian Vital Statistics (Death) Database (CVSD) compiles demographic and medical (cause of death) information annually from all provincial and territorial vital statistics registries on all deaths in Canada (Statistics Canada n.d.d). Deaths occurring from 1970 through 2012 were available for linkage (n = 8,574,561, which includes 731,953 deaths for the 2010-to-2012 period).

3 Record linkage

The linkage was conducted at Statistics Canada using the Social Data Linkage Environment (SDLE), a highly secure linkage environment facilitating the creation of linked population data files for social analysis. The linkage was conducted separately for each database in three steps: (1) data preparation, (2) record linkage, and (3) quality assessment. Given the unique nature of each database, different linking variables, methodologies, and quality assessment measures were employed (Table 1). 

3.1 Data preparation

For all four databases—CCR, DAD, NACRS, and CVSD—data preparation included a quality assessment of the linkage variables to determine the completeness and the validity of the data. This procedure identifies data errors or omissions that may impede correct linkage of a record. The choice of linkage variables has a direct impact on the efficiency of the record linkage operation. Information associated with the linkage variables must be accurately recorded, available for the vast majority (if not all) of individuals in the files to be linked, and as discriminating as possible. Each file contained a different set of linkage variables (Table 1). Exclusion criteria varied depending on the linkage strategy. 

Table 1
Summary of linkage methodology
Table summary
This table displays the results of Summary of linkage methodology . The information is grouped by Input data file (appearing as row headers), Number of records, Linkage variables, Exclusion criteria (number of records), Record linkage method and Quality assessment (appearing as column headers).
Input data file Number of records Linkage variables Exclusion criteria (number of records) Record linkage method Quality assessment
CCR 3,126,295 Date of birth, date of death, sex, postal code, city, CSD code, names (given, surnames, CCR alternate names) None Probabilistic
(G-Link)
Sensitivity

Specificity
DAD 77,925,269 Date of birth, postal code, sex, HIN Records with incomplete date of birth, sex or postal code Deterministic False positive
NACRS 166,069,085 Date of birth, postal code, sex, HIN Records with incomplete date of birth, sex or postal code Deterministic False positive
CVSD 8,574,561 Date of birth, date of death, sex, postal code, city, CSD code, names (given, surnames including parents and spouse surname) Records with names missing (765 records) Probabilistic
(G-Link)
Sensitivity
Specificity

Exclusion criteria were applied to each input data set, where applicable. Because the DAD and the NACRS were linked deterministically using only three variables, missing information for any of the three variables would make an accurate linkage impossible. 

In addition, a separate processing step was applied to the CCR to identify unique individuals. Individuals may be represented in the CCR more than once if they were diagnosed with cancer more than once. The CCR data file was unduplicated within provinces and territories, thereby facilitating linkage at the person level rather than the tumour level. This process identified 3,053,697 unique individual–province combinations. An individual diagnosed with multiple cancers in different provinces or territories would be represented more than once. To handle this situation, the CCR was linked with an N:1 correspondence, that is, more than one individual–province combination could have linked to one DAD record.

3.2 Record linkage methodology

The linkage was conducted at Statistics Canada in the SDLE. At the core of the SDLE is a Derived Record Depository (DRD), a national dynamic relational database containing only basic personal identifiers created by linking selected Statistics Canada source index files in order to produce a list of unique individuals. Each input data file (CCR, NACRS, DAD, CVSD) was separately linked to the DRD using methods appropriate to the availability of linkage variables. The following describes the linkage methodology used for each input file. The methods are summarized in Table 1.

3.3 Canadian Cancer Registry

The CCR was linked to the DRD using G-Link, a generalized record linkage system developed by Statistics Canada based on probabilistic linkage methodology developed by Ivan P. Fellegi and Alan B. Sunter. Probabilistic record linkage uses non-unique identifiers (such as name and birth date) to calculate the likelihood that records refer to the same entity (for example, individual). Probabilistic record linkage is especially valuable when the identifiers are subject to change (females’ surnames, for instance), error-prone, or frequently missing. The linkage was conducted using a range of linkage variables, including dates of birth and death, names, and geographic locations (Table 1). If CCR records contained health insurance numbers (HINs), this information was included in the DRD to facilitate linkage to the hospital data. Overall, 95.87% (n = 2,927,463) of unique individual–province identifiers in the CCR were linked to the DRD.

3.4 Discharge Abstract Database and National Ambulatory Care Reporting System

The DAD and NACRS data were linked to the DRD using a two-phase deterministic linkage. In the first phase, a linkage key was created based on sex, date of birth, and postal code for records with complete information (n = 164,649,442). That key was used to deterministically link records to the DRD. Only unique exact matches were retained (only one DRD record linked with a given key). During this phase, HINs in the DAD and the NACRS were extracted and included in the DRD as an additional unique identifier to facilitate future linkages. In the second phase, unlinked records were deterministically linked (exact match) to the DRD using only HINs.

The NACRS was linked first to the DRD. In the first phase, 78.9% (n = 129,985,322) of NACRS records with a valid key were linked to the DRD. A total of 2,895,602 links were broken, reflecting cases where a NACRS record linked to two different people on the DRD, and the conflict could not be resolved with available information. A further 22,953,303 links were created among NACRS records sharing the same HIN, resulting in a total linkage rate of 90.3%.

For the DAD data, 71.2% (n = 55,015,973) of records were linked to the DRD. Another 4,770,333 links were broken, reflecting cases where a DAD record linked to two different people on the DRD, and given the available information, the conflict could not be resolved. A further 11,230,936 links were created among DAD records sharing the same HIN, resulting in a total linkage rate of 85.0%.

3.5 Canadian Vital Statistics Database

The CVSD was linked to the DRD using probabilistic linkage. The linkage was conducted with a range of linkage variables, including dates of birth and death, names, and geographic locations. Overall, 67.1% (n = 5,749,144) of individuals were linked to the DRD. This low rate was expected, given the poor coverage of the DRD before 1980. For the study period (2010 to 2012), the linkage rate was 97.7% (714,825 divided by 731,953).

3.6 Quality assessment

Error estimation was conducted for each linkage to assess the quality of the linkage of each input file to the DRD. For the CCR, sensitivity (true linkage rate) and specificity (true non-linkage rate) were calculated by comparing the results of G-Link to a manual review of a randomly selected sample of links and non-links. The quality of the linkage was deemed high, with sensitivity and specificity rates of 97.74% and 99.36%, respectively. For the CVSD, the sensitivity was 95.4% for the 1970-to-2011 period and 98.4% for 2012. Specificity was 97.8% for the 1970-to-2011 period and 83.5% for 2012.

No manual review was conducted to determine error rates for the DAD and NACRS linkages. However, results of the second phase using HINs provide some measure of the error rate:   0.01% (n = 9,757) of DAD transactions and 0.003% (n = 5,718) of NACRS transactions were linked to different persons in the two phases.

4 Surgical treatment

Further validation was conducted to determine the fitness of the linked data for reporting surgical treatment for six cancer types—female breast, colorectal, prostate, urinary bladder, thyroid, and lung and bronchus—the leading types of new cancers in Canada (Canadian Cancer Society’s Advisory Committee on Cancer Statistics 2014). Furthermore, treatment for these cancers typically requires surgical intervention. The following describes the tumour selection process, linkage rates, and treatment rates for these cancers.

4.1 Cohort selection

A cohort of new primary malignant cancer tumours was selected, consisting of people aged 19 or older diagnosed from January 1, 2010, through December 31, 2012. For urinary bladder cancer, in situ tumours were also included. International Classification of Diseases for Oncology, Third Edition (ICD-O-3) (Fritz et al. 2000) codes were used to define the tumour cohort; these were grouped using Surveillance, Epidemiology, and End Results (SEER) Program grouping definitions (Horner et al. n.d.) (Table 2). Histology for all cancer types excluded: mesothelioma (M-9050 to M-9055), Kaposi sarcoma (M-9140), and hematopoietic and lymphoid neoplasms (M-9590 to M-9992).

Table 2
International Classification of Diseases for Oncology, Third Edition (ICD-O-3) Codes for selecting cancer tumour types
Table summary
This table displays the results of International Classification of Diseases for Oncology. The information is grouped by Type (appearing as row headers), ICD-O-3 Codes (appearing as column headers).
Type ICD-O-3 Codes
Breast C50.0 to C50.9
Colorectal
Colon C18.0, C18.2 to C18.9; C26.0 (C18.1 appendix was excluded)
Rectum/rectosigmoid junction C19.9, C20.9
Prostate C61.9
Lung and bronchus C34.0 to C34.9
Urinary bladderTable 2 Note 1 C67.0 to C67.9
Thyroid C73.9

To determine a single primary tumour for each individual, the International Agency for Research on Cancer (IARC) rules (International Agency for Research on Cancer et al. 2004) for multiple primary tumours were applied to the CCR. In general, application of these rules removes subsequent tumours of the same type and histology. This modified CCR file forms the basis of the data released by Statistics Canada to the public (Statistics Canada n.d.e) and is accessible to researchers in the Research Data Centres (RDCs). The file is called the IARC Tabulation Master File (TMF) (Statistics Canada 2008).

Individuals may be represented in the IARC TMF more than once if, for example, they were diagnosed with more than one tumour of the same type but of a different histology. To assign surgical treatment at the individual level, it was necessary to ensure that only one tumour of a given type was included for each cancer patient. Hence, a further review of the IARC TMF was conducted to remove tumour records in cases where multiple tumours of the same type were identified for the same patient occurring one year before and/or one year after the date of diagnosis of the primary tumour. This would remove cases of multiple tumours of the same type but different histology, for example. 

Reported treatment rates were not age- or sex-adjusted. However in addition to overall surgical treatment rates, rates were produced by sex and by age group (19 to 49, 50 to 69, and 70 or older).

4.2 Treatment codes

A comprehensive list of potential surgical treatments was developed for each cancer type, based on published sources, including the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines) (NCCN 2002, 2013a, 2013b, 2014, 2015a, 2015b, 2015c, 2016) and Facility Oncology Registry Data Standards (FORDS) (Commission on Cancer 2002). The lists pertinent to breast, colorectal and prostate cancers had previously been reviewed by members of the feasibility national advisory committee, technical experts at the provincial cancer agencies, and clinical experts when required (Carrière et al. 2015). After consultations, a final set of surgical treatments was selected. For the three additional cancer types, the initial list of treatments was reviewed, and consultations were held with clinical experts and classification experts from CIHI. Appendix B contains the list of surgical interventions included for each cancer type.

The Canadian Classification of Health Interventions (CCI), versions 2009 and 2012, (CIHI 2009a, 2012a) were used to define the surgical intervention in the DAD and NACRS. All intervention fields in the DAD (20) and NACRS (10) records were used to identify the surgical interventions associated with each cancer type. This was done independently for each surgical treatment code because multiple treatments in a single hospital admission are captured as separate treatment events.

4.3 Follow-up period

Surgical treatments occurring within one year after or 31 days before the tumour date of diagnosis recorded on the CCR were considered. The admission date recorded in the DAD and the NACRS was used to determine the eligibility of interventions contained in the record. 

4.4 Reporting facility type

The DAD and the NACRS represent different frames of hospital services that are expected to have an impact on reporting treatment rates. The DAD includes all discharges from all acute care facilities for all territories and provinces, except Quebec, and represents about 75% of all acute separations for Canada (CIHI 2012c). For the reference period of this analysis (fiscal years 2009/2010 through 2013/2014), health service facilities reported same-day surgery visits to the DAD and/or to the NACRS depending on the year and jurisdiction (CIHI 2009b, 2010b, 2011b, 2011c, 2011d, 2012d, 2012e, 2014b, 2015b). Around 2.4 million day-surgery visits are submitted to CIHI annually—35% are sent to the DAD, and 65%, to the NACRS (CIHI 2012d).

The NACRS includes a broader range of services: emergency room visits, day surgery, oncology clinics, Cancer Care Ontario for oncology care, and other types of ambulatory care (for example, renal dialysis clinics) (CIHI 2009b, 2010b, 2011b, 2011c, 2011d, 2012d, 2012e, 2014b, 2015b). The data for provinces that report surgical events to the NACRS offer a greater opportunity to link tumours to surgical treatments (for instance, emergency departments, oncology clinics) than is available for provinces not reporting visits for the same range of services to the NACRS. Consequently, overall treatment rates are expected to be higher in jurisdictions with wider ranges of surgical event coverage. Table 3 displays information on coverage, by reference year, for all jurisdictions. CIHI offers guidelines to prevent double-counting of day-surgery events between the DAD and the NACRS (CIHI 2009b).

Table 3
NACRS coverage by year and province or territory (excluding Quebec), 2009/2010 to 2013/2014
Table summary
This table displays the results of NACRS coverage by year and province or territory (excluding Quebec). The information is grouped by Province and Territories (appearing as row headers), 2009/2010, 2010/2011, 2011/2012, 2012/2013 and 2013/2014 (appearing as column headers).
Province and Territories 2009/2010 2010/2011 2011/2012 2012/2013 2013/2014
Newfoundland and Labrador Note ...: not applicable Note ...: not applicable Note ...: not applicable NACRS ED Note ...: not applicable
Prince Edward Island NACRS ED NACRS ED NACRS ED NACRS ED NACRS ED
Nova Scotia NACRS ED/DS NACRS ED/DS All NACRS All NACRS All NACRS
New Brunswick Note ...: not applicable Note ...: not applicable Note ...: not applicable Note ...: not applicable Note ...: not applicable
Ontario All NACRS All NACRS All NACRS All NACRS All NACRS
Manitoba NACRS ED NACRS ED NACRS ED NACRS ED NACRS ED
Sasktchewan Note ...: not applicable NACRS ED NACRS ED NACRS ED NACRS ED
Alberta Note ...: not applicable All NACRS All NACRS All NACRS All NACRS
British Columbia NACRS ED NACRS ED NACRS ED NACRS ED NACRS ED
Yukon NACRS ED NACRS ED NACRS ED NACRS ED NACRS ED
Northwest Territories Note ...: not applicable Note ...: not applicable Note ...: not applicable Note ...: not applicable Note ...: not applicable
Nunavut Note ...: not applicable Note ...: not applicable Note ...: not applicable Note ...: not applicable Note ...: not applicable

All in-scope records that contained one or more of the selected surgical interventions that had linked to the six types of cancers in the cohort were considered for analysis of treatment rates; no exclusions based on reporting facility type were applied. Surgeries to treat these cancers can occur outside hospital settings; for example, at specific cancer centres (Winnipeg Regional Health Authority n.d.), in practitioners’ offices, and at private clinics. Surgeries performed in those settings were not included in this analysis.

4.5 Surgical treatment rates

Surgical treatment rates for each cancer type are reported by province, and year. Numerators are the number of tumours having at least one occurrence of the selected surgical intervention during the follow-up period. Denominators are the total number of tumours in the CCTLP Tumour Cohort (CCTLP-TC).

5 Results

5.1 Cohort selection

Table 4 presents the selection process for the CCTLP-TC. Overall, 225,330 single primary cancer tumours were selected, representing 97.4% of tumours of the same site reported in the CCR tumour file. 

Table 4
Number of primary malignant cancer tumours diagnosed among population aged 19 or older, by cancer type and data source, Canada (excluding Quebec), 2010 to 2012
Table summary
This table displays the results of Number of primary malignant cancer tumours diagnosed among population aged 19 or older. The information is grouped by Primary cancer site (appearing as row headers), CCR Tabulation Master File
(Step A), IARC Tabulation Master File
(Step B), CCTLP Tumour Cohort
(Step C) and CCTLP Tumour
Cohort coverage (Step C / Step A), calculated using number and percentage units of measure (appearing as column headers).
Primary cancer site CCR Tabulation Master File
(Step A)
IARC Tabulation Master File
(Step B)
CCTLP Tumour Cohort
(Step C)
CCTLP Tumour
Cohort coverage (Step C / Step A)
number percentage
Female breast 52,235 51,775 50,740 97.1
Colon and rectum 47,555 45,990 44,970 94.6
Prostate 53,425 53,395 52,905 99.0
Urinary bladder 15,280 15,250 14,990 98.1
Thyroid 12,750 12,750 12,585 98.7
Lung and bronchus 50,110 49,830 49,135 98.1
Total 231,355 228,990 225,330 97.4

The linked tumour cohort median patient age for female breast cancer ranged from 59 to 65 across provinces; for colorectal, from 68 to 73; for prostate, from 65 to 69; for lung and bronchus, from 69 to 72; for urinary bladder, from 66 to 76; and for thyroid, from 47 to 57 (data not shown). 

Because cancer outcomes vary for men and women, distributions by sex for four cancer sites were considered. In the linked tumour cohort and across jurisdictions, men accounted for about three-quarters (75% to 76%) of urinary bladder tumours; just over half of colorectal (54% to 55%) and lung and bronchus tumours (51% to 52%); and one-fifth to one-quarter (22% to 24%) of thyroid tumours (data not shown).

5.2 Linkage results for the Canadian Cancer Treatment Linkage Project-Tumour Cohort

Overall, 99% of cancer tumours were linked to the DRD, rendering them eligible to link to a hospital record. Rates were consistent across provinces and territories (where reportable), but were lower for lung and bronchus tumours diagnosed in Nunavut (Table A.1).

Three-year linkage rates for the DAD and NACRS (2009/2010 to 2012/2013) files that were used to identify surgical interventions were greater than 90%. Linkage rates varied across provinces; the lowest levels were reported for the Northwest Territories and Nunavut (Table A.2).

5.3 Treatment rates

Tables 5 to 10 show the percentage of tumours receiving at least one type of surgical intervention during the follow-up period for each type of cancer.  The results are presented for all years of data combined. An examination of rates by single years revealed consistent patterns across years (data not shown).

The majority (88%) of female breast cancer tumours received a surgical intervention, with rates ranging from 85% in Manitoba to 92% in Prince Edward Island (Table 5). Rates in the territories were more variable (84% to 93%), owing to smaller numbers of cases. Surgical rates varied by patient age, with the highest among women younger than 70 (Table A.3).

Table 5
Percentage of female breast cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis, by province or territory, Canada (excluding Quebec), 2010 to 2012
Table summary
This table displays the results of Percentage of female breast cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis Linked CCTLP Tumour Cohort and Tumours with one or more surgical interventions, calculated using number and percentage units of measure (appearing as column headers).
Linked CCTLP Tumour Cohort Tumours with one or more surgical interventions
number number percentage
Canada (excluding Quebec) 50,740 44,780 88.2
Newfoundland and Labrador 1,055 965 91.5
Prince Edward Island 330 305 91.8
Nova Scotia 2,090 1,875 89.7
New Brunswick 1,555 1,410 90.7
Ontario 26,095 22,565 86.5
Manitoba 2,390 2,040 85.3
Saskatchewan 1,940 1,740 89.6
Alberta 6,185 5,575 90.1
British Columbia 8,970 8,195 91.3
Yukon 60 50 84.2
Northwest Territories 60 50 86.7
Nunavut 15 15 93.3

Similarly, the majority (83%) of colorectal cancer tumours received a surgical intervention, with rates ranging from 81% to 82% in Ontario and Manitoba to 87% in Newfoundland and Labrador and in British Columbia (Table 6). Because of the smaller numbers of cases, rates for the territories were variable. Colorectal surgical rates were highest at ages 50 to 69 (Table A.4).

Table 6
Percentage of colorectal cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis, by province or territory, Canada (excluding Quebec), 2010 to 2012
Table summary
This table displays the results of Percentage of colorectal cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis Linked CCTLP Tumour Cohort and Tumours with one or more surgical interventions, calculated using number and percentage units of measure (appearing as column headers).
Linked CCTLP Tumour Cohort Tumours with one or more surgical interventions
number number percentage
Canada (excluding Quebec) 44,970 37,315 83.0
Newfoundland and Labrador 1,495 1,295 86.5
Prince Edward Island 300 250 82.5
Nova Scotia 2,330 1,930 82.9
New Brunswick 1,545 1,275 82.5
Ontario 21,510 17,440 81.1
Manitoba 2,385 1,945 81.7
Saskatchewan 2,070 1,745 84.2
Alberta 5,145 4,320 84.0
British Columbia 8,050 6,995 86.9
Yukon 45 40 87.0
Northwest Territories 70 60 84.5
Nunavut 25 20 88.5

Overall, about a third (31%) of prostate cancer tumours received a surgical intervention. Rates ranged from 17% in Prince Edward Island to 35% in Newfoundland and Labrador and Nova Scotia (Table 7). Annual surgical rates varied considerably (10% to 22%) in Prince Edward Island, a result of the relatively small number of cases in that province (data not shown). In all jurisdictions, the highest rate of surgical intervention was at ages 19 to 49 (Table A.5).

Table 7
Percentage of prostate cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis, by province or territory, Canada (excluding Quebec), 2010 to 2012
Table summary
This table displays the results of Percentage of prostate cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis Linked CCTLP Tumour Cohort and Tumours with one or more surgical interventions, calculated using number and percentage units of measure (appearing as column headers).
Linked CCTLP Tumour Cohort Tumours with one or more surgical interventions
number number percentage
Canada (excluding Quebec) 52,905 16,480 31
Newfoundland and Labrador 1,350 470 35
Prince Edward Island 420 70 17
Nova Scotia 2,210 775 35
New Brunswick 1,965 490 25
Ontario 26,135 8,085 31
Manitoba 2,045 570 28
Saskatchewan 2,100 515 25
Alberta 6,835 2,325 34
British Columbia 9,765 3,145 32
Yukon 50 30 45
Northwest Territories Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Nunavut Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act

Of the six selected cancer sites, lung and bronchus tumours had the lowest surgical rates—overall, 19% received at least one of surgical intervention. Rates ranged from 14% in Prince Edward Island to 25% in New Brunswick (Table 8). In all jurisdictions, rates were highest at ages 19 to 49 (Table A.6).

Table 8
Percentage of lung and bronchus cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis, by province or territory, Canada (excluding Quebec), 2010 to 2012
Table summary
This table displays the results of Percentage of lung and bronchus cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis Linked CCTLP Tumour Cohort and Tumours with one or more surgical interventions, calculated using number and percent units of measure (appearing as column headers).
Linked CCTLP Tumour Cohort Tumours with one or more surgical interventions
number number percent
Canada (excluding Quebec) 49,135 9,380 19.1
Newfoundland and Labrador 1,245 195 15.6
Prince Edward Island 360 50 13.6
Nova Scotia 2,680 535 20.0
New Brunswick 1,950 490 25.1
Ontario 24,205 4,765 19.7
Manitoba 2,460 560 22.9
Saskatchewan 2,200 385 17.5
Alberta 5,425 955 17.6
British Columbia 8,475 1,420 16.8
Yukon 50 10 19.6
Northwest Territories Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Nunavut Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act

A large majority (91%) of bladder tumours received surgical treatment; rates were high in all jurisdictions, ranging from 88% in Manitoba and Ontario to 94% in Newfoundland and Labrador (Table 9). The highest rates were at ages 50 to 69 (Table A.7).

Table 9
Percentage of urinary bladder (including in situ) cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis, by province or territory, Canada (excluding Quebec),
2010 to 2012
Table summary
This table displays the results of Percentage of urinary bladder (including in situ) cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis Linked CCTLP Tumour Cohort and Tumours with one or more surgical interventions, calculated using number and percent units of measure (appearing as column headers).
Linked CCTLP Tumour Cohort Tumours with one or more surgical interventions
number number percent
Canada (excluding Quebec) 14,990 13,590 91
Newfoundland and Labrador 380 355 94
Prince Edward Island 105 100 92
Nova Scotia 845 785 93
New Brunswick 675 620 92
Ontario 6,055 5,360 88
Manitoba 765 675 88
Saskatchewan 740 680 92
Alberta 2,090 1,910 92
British Columbia 3,315 3,075 93
Yukon 15 15 88
Northwest Territories Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Nunavut Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act

Most thyroid tumours received at least one surgical treatment. The overall rate was 93%, ranging from 91% in Prince Edward Island, Manitoba and British Columbia to 98% in Newfoundland and Labrador (Table 10).  Thyroid surgical patients tended to be younger than those who had surgery on other cancer sites; the lowest rates were among patients aged 70 or older (Table A.8).

Table 10
Percentage of thyroid cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis, by province or territory, Canada (excluding Quebec), 2010 to 2012
Table summary
This table displays the results of Percentage of thyroid cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis Linked CCTLP Tumour Cohort and Tumours with one or more surgical interventions, calculated using number and percent units of measure (appearing as column headers).
Linked CCTLP Tumour Cohort Tumours with one or more surgical interventions
number number percent
Canada (excluding Quebec) 12,585 11,700 93
Newfoundland and Labrador 315 310 98
Prince Edward Island 35 30 91
Nova Scotia 360 345 96
New Brunswick 410 400 97
Ontario 8,320 7,690 92
Manitoba 380 350 91
Saskatchewan 280 265 95
Alberta 1,340 1,270 95
British Columbia 1,125 1,030 91
Yukon Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Northwest Territories 5 5 86
Nunavut Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act

6 Discussion

This study demonstrates how record linkage can be used to add surgical treatment information to a national cancer registry. By means of the SDLE platform at Statistics Canada, most records in the CCR, the DAD and the NACRS were linked. The surgical treatment rates for the six selected cancers derived from the linked data reflected expected values. Because they are based on the majority of tumours of the selected types diagnosed between 2010 and 2012, the results are deemed unbiased and representative of the surgical treatment experience of cancer patients in Canada.

The linkage rates achieved for each input file were 90% or better; the rate was 99% for the selected cancer tumours diagnosed from 2010 to 2012 among adult patients. For the DAD, rates were highest for the most recent years of data and for records representing patients aged 19 or older.

An advantage of conducting the linkage at the national level is the ability to capture surgical treatments occurring outside patients’ province or territory of residence. Generally, national-level linkage rates equal or exceed rates from previous linkage projects (Carrière et al. 2015; Rotermann et al. 2014, 2015). Nonetheless, some regional variation in linkage rates was apparent for the DAD. Continued efforts are required to improve DAD linkage rates, specifically, for selected regions, including the Northwest Territories and Nunavut, to ensure comparability.

DAD linkage rates were higher when HINs were available. However, not all cancer registries currently report HINs to the CCR. Continued use of HINs as a linkage variable would increase the pan-Canadian linkage rate, but differentially affect rates for reporting and non-reporting provinces and territories. Requesting HINs is part of the CCR annual cancer data call; comprehensive submission from all provincial and territorial cancer registries would help to resolve this issue. In addition, an assessment of the quality of HIN reporting to the CCR should be undertaken before it is assigned a primary role in linkage with the DAD or other datasets.

Surgical treatment rates derived from the linked CCRDAD–NACRs data are generally at expected levels and comparable to published information on surgical rates. As anticipated, surgical rates varied by cancer site and were higher for breast, colorectal, urinary bladder, and thyroid cancers, compared with lung cancer, for which survival outcomes are poor, and prostate cancer, for which ” active surveillance” may be the preferred approach (Dragomir, Cury and Aprikian 2014).

The results of this study indicated that breast-conserving surgery and mastectomy were the most prevalent types of surgical treatment for breast cancer. Other published sources have identified these surgeries as integral to breast cancer treatment (Urbach, Simunovic and Schultz 2008; Quan et al. 2008; CIHI and CPAC 2012; Turner et al. 2007). Combined breast-conserving surgery and/or mastectomy rates resemble those previously reported for Ontario and Manitoba (Quan et al. 2008; CIHI and CPAC 2012; Turner et al. 2007). Furthermore, disaggregated breast surgical rates used for validation (data not shown) showed similarities to published results for cancer system performance reports (CPAC 2012, 2016). Compared with rates calculated for four provinces during the 2005-to-2008 period (Carrière et al. 2015), the breast surgery rates in this study are slightly lower or higher, possibly because of different linkage approaches. This demonstrates that use of the SDLE platform yielded higher rates for breast surgeries for two provinces than had been obtained via direct linkage using only HINs reported to the CCR in the earlier feasibility study.

The present analyses revealed differences in breast surgery by patient age (data not shown). Therefore, some variation in treatment rates across jurisdictions or in comparison with other reports is due, in part, to differences in the age distribution of this cohort. Further analysis is required to assess treatment rates for all six cancers by patient characteristics and cancer stage.

Surgery rates for colorectal cancer in Ontario were similar to published findings (Carrière et al. 2015; Nenshi et al. 2008). Surgical treatment rates were highest at ages 19 to 49, consistent with results noted in the earlier feasibility report (Carrière et al. 2015).

A decade ago, an analysis of U.S. data found that 93.4% of nearly 54,000 thyroid cancers (histologies taken together) received surgical treatment (thyroidectomy and/or lymph node sampling and/or dissection) (Hundahl et al. 1998). According to the present study, 93% of thyroid tumours received at least one surgical treatment, primarily thyroidectomy.

Patients with urinary bladder cancer frequently experience recurrence (Kassouf et al. 2010), and with the prevalence of this cancer being 10 times its incidence (Kassouf et al. 2010), the likelihood of at least one surgical treatment was expected to be high. In fact, rates consistently exceeded 91%. Treatment rates were not calculated by tumour stage; however, this likely would impact rates for surgery. A retrospective review using Alberta Cancer Registry data from 2007 to 2011 reported that overall, 27.8% of high-grade T1 bladder cancer experienced early repeat resection, and that by 2011, the rate had increased to 37.8% (Gotto, Shea-Budgell, and Ruether 2016). For future analyses, the record linkage approach in this study would enable measurement of changes in surgical patterns across time.

The utility of linked data about surgery for cancer depends in part on the accuracy and comprehensiveness of hospital data. Evidence suggests that cancer registry information about surgical treatment is more complete than information in the DAD (Turner et al. 2007). Consequently, this analysis may underestimate treatment rates. As well, DAD and NACRS coding standards may limit the degree to which the data can be used to report specific surgical interventions. For example, previous research found lower-than-expected rates of lymph node removal for breast and prostate cancer (Carrière et al. 2015). This was attributed, in part, to the fact that multiple axillary lymph node procedures are not always recorded separately in the DAD when radical mastectomy and prostatectomy are performed. Therefore, obtaining comprehensive or absolute counts of lymph node interventions is not feasible for all years of DAD and NACRS data. Mandatory reporting guidelines may have addressed this issue in more recent years of DAD and NACRS data. Further analyses of these newly linked data are required to determine the accuracy of reporting more specific surgical interventions.

Finally, results of this and previous studies have demonstrated the feasibility of using hospital data (such as data from the DAD and NACRS) linked to cancer registry data to derive surgical treatment rates. This approach is appropriate when interventions occur primarily in hospital or clinic settings that report to one of the two national hospital data sources. It may not be appropriate for some types of cancers (such as skin cancer) for which surgical interventions may occur in physicians’ offices. Linkage to physician claims data would be required to capture this information. 

7 Limitations

Although the linkage rates were considered to be robust for both the DAD and NACRS, the 8% of non-linking cases potentially represent missed surgical treatments. Furthermore, the feasibility of using record linkage to capture surgical interventions to report on treatment for childhood cancers warrants further investigation, as overall linkage rates for DAD records related to children were generally lower (data not shown).

The current study was based on the majority of tumours (97.4%) of the selected cancer types, excluding  cases where: (1) more than one primary tumour in the same organ was reported to the CCR; (2) the diagnosis dates were within 365 days of each other; and (3) the tumour record did not link in the SDLE. The overall impact was a loss of 2.6% of tumours reported to the CCR. Colorectal cases were most affected, with a loss of 5.4%, followed by female breast with a loss of 2.9%. The impact of multiple tumours may be more pronounced for other cancer sites. Given the overall high linkage rate for the CCR, most exclusions were based on criteria 1 and 2. The challenge presented by multiple tumours is proper attribution of a surgical intervention. The results of this study cannot be generalized to cases with multiple tumours. Future work should focus on determining the feasibility of using record linkage to correctly assign surgical information to the appropriate tumour in such cases.

Except for urinary bladder cancer, this study did not include in situ tumours. Future studies should attempt to include them, and thereby, determine the feasibility of using linked data to report on treatment rates for these tumours.

Surgical treatments that may have occurred outside of hospital settings, for example, prostate surgery in physician’s office or surgery at the Winnipeg Breast Health Centre (Winnipeg Regional Health Authority n.d.) were not captured in the data used in this study. Therefore, surgical treatment rates are slightly underestimated.

8 Conclusions

Results of this study demonstrate the feasibility of using record linkage to bring together information in cancer registries with surgical intervention information in hospital data. The use of Statistics Canada’s linkage environment, SDLE, is a viable, cost-effective method of adding surgical treatment data to the CCR, and thereby, enhancing the capacity to report on a key treatment modality at the national level. Future work should focus on continued improvement of linkage rates, specifically, for hospital data; the feasibility of extending this approach to cases representing multiple tumours, younger patients, and other types of cancers; and the quality of surgical data. 

Appendix A – Additional tables on linkage results

Table A.1-1
Number and percentage of tumours from the CCTLP Tumour Cohort that are linked to the DRD, by type of cancer and province or territory, Canada (excluding Quebec), 2010 to 2012 — Female breast, colorectal and prostate cancers
Table summary
This table displays the results of Number and percentage of tumours from the CCTLP Tumour Cohort that are linked to the DRD CCTLP Tumour Cohort and Tumour records linked to DRD, calculated using number and percent units of measure (appearing as column headers).
CCTLP Tumour Cohort Tumour records linked to DRD
number number percent
Female breast
Canada 51,200 50,740 99.1
Newfoundland and Labrador 1,070 1,055 98.5
Prince Edward Island 330 330 100.0
Nova Scotia 2,100 2,090 99.5
New Brunswick 1,565 1,555 99.4
Ontario 26,385 26,095 98.9
Manitoba 2,405 2,390 99.5
Saskatchewan 1,955 1,940 99.2
Alberta 6,220 6,185 99.4
British Columbia 9,035 8,970 99.3
Yukon 60 60 100.0
Northwest Territories 60 60 100.0
Nunavut 15 15 100.0
Colorectal
Canada 45,450 44,970 99.0
Newfoundland and Labrador 1,515 1,495 98.7
Prince Edward Island 305 300 99.0
Nova Scotia 2,340 2,330 99.4
New Brunswick 1,555 1,545 99.4
Ontario 21,805 21,510 98.6
Manitoba 2,400 2,385 99.3
Saskatchewan 2,090 2,070 99.0
Alberta 5,175 5,145 99.4
British Columbia 8,110 8,050 99.2
Yukon 50 45 97.9
Northwest Territories 70 70 98.6
Nunavut 30 25 92.9
Prostate
Canada 53,355 52,905 99.2
Newfoundland and Labrador 1,360 1,350 99.2
Prince Edward Island 420 420 99.8
Nova Scotia 2,220 2,210 99.4
New Brunswick 1,975 1,965 99.3
Ontario 26,440 26,135 98.9
Manitoba 2,055 2,045 99.5
Saskatchewan 2,110 2,100 99.4
Alberta 6,865 6,830 99.5
British Columbia 9,820 9,765 99.4
Yukon 50 50 100.0
Northwest Territories 25 25 100.0
Nunavut 10 10 90.0
Table A.1-2
Number and percentage of tumours from the CCTLP Tumour Cohort that are linked to the DRD, by type of cancer and province or territory, Canada (excluding Quebec), 2010 to 2012 — Urinary bladder, thyroid, and lung and bronchus cancers
Table summary
This table displays the results of Number and percentage of tumours from the CCTLP Tumour Cohort that are linked to the DRD CCTLP Tumour Cohort and Tumour records linked to DRD, calculated using number and percent units of measure (appearing as column headers).
CCTLP Tumour Cohort Tumour records linked to DRD
number number percent
Urinary bladder (including in situ)
Canada 15,125 14,990 99.1
Newfoundland and Labrador 380 380 99.2
Prince Edward Island 105 105 99.1
Nova Scotia 855 840 98.8
New Brunswick 680 675 99.6
Ontario 6,120 6,055 99.0
Manitoba 770 765 99.4
Saskatchewan 745 740 99.3
Alberta 2,095 2,090 99.6
British Columbia 3,345 3,315 99.1
Yukon 20 15 89.5
Northwest Territories Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Nunavut Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Thyroid
Canada 12,710 12,585 99.0
Newfoundland and Labrador 315 315 100.0
Prince Edward Island 30 30 100.0
Nova Scotia 360 360 100.0
New Brunswick 415 410 99.5
Ontario 8,425 8,320 98.8
Manitoba 385 380 99.5
Saskatchewan 280 280 98.9
Alberta 1,350 1,340 99.2
British Columbia 1,135 1,125 99.4
Yukon Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Northwest Territories 5 5 100.0
Nunavut Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Lung and bronchus
Canada 49,570 49,135 99.1
Newfoundland and Labrador 1,260 1,245 99.0
Prince Edward Island 360 360 99.7
Nova Scotia 2,700 2,680 99.3
New Brunswick 1,960 1,950 99.3
Ontario 24,460 24,205 99.0
Manitoba 2,470 2,456 99.5
Saskatchewan 2,215 2,200 99.3
Alberta 5,465 5,425 99.3
British Columbia 8,530 8,475 99.3
Yukon 50 50 98.1
Northwest Territories 45 45 100.0
Nunavut 50 45 90.2
Table A.2-1
Number and percentage of DAD and NACRS records linked to the DRD, by province or territory, Canada (excluding Quebec), 2009/2010 through 2013/2014 — Part 1
Table summary
This table displays the results of Number and percentage of DAD and NACRS records linked to the DRD DAD records, DAD records linked
to DRD, NACRS records and NACRS records linked
to DRD, calculated using number and percent units of measure (appearing as column headers).
DAD records DAD records linked
to DRD
NACRS records NACRS records linked
to DRD
number number percent number number percent
Fiscal year 2009/2010
Canada (excluding Quebec) 2,745,705 2,520,970 91.8 8,028,690 7,485,470 93.2
Newfoundland and Labrador 117,230 102,665 87.6 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Prince Edward Island 24,695 20,480 82.9 22,045 20,155 91.4
Nova Scotia 183,875 171,920 93.5 59,900 55,130 92.0
New Brunswick 127,990 108,795 85.0 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Ontario 869,990 816,090 93.8 7,819,305 7,294,805 93.3
Manitoba 206,765 178,290 86.2 88,140 79,975 90.7
Saskatchewan 209,545 193,925 92.5 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Alberta 291,535 268,105 92.0 Note ...: not applicable Note ...: not applicable Note ...: not applicable
British Columbia 700,930 652,390 93.1 17,410 16,165 92.8
Yukon 4,350 3,830 88.0 21,885 19,240 87.9
Northwest Territories 7,020 3,670 52.3 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Nunavut 1,795 825 46.0 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Fiscal year 2010/2011
Canada (excluding Quebec) 2,767,960 2,549,220 92.1 14,021,400 13,053,095 93.1
Newfoundland and Labrador 118,075 103,660 87.8 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Prince Edward Island 24,530 20,315 82.8 20,785 19,050 91.6
Nova Scotia 182,895 170,980 93.5 54,740 50,280 91.9
New Brunswick 126,615 107,765 85.1 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Ontario 874,065 820,445 93.9 7,756,950 7,236,430 93.3
Manitoba 207,840 181,775 87.5 250,740 226,660 90.4
Saskatchewan 209,565 194,320 92.7 6,640 5,685 85.6
Alberta 293,040 272,485 93.0 5,908,865 5,495,200 93.0
British Columbia 718,060 669,025 93.2 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Yukon 4,430 3,900 88.1 22,680 19,785 87.3
Northwest Territories 7,120 3,820 53.6 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Nunavut 1,730 735 42.5 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Fiscal year 2011/2012
Canada (excluding Quebec) 2,710,770 2,499,585 92.2 14,904,220 13,848,210 92.9
Newfoundland and Labrador 118,100 104,070 88.1 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Prince Edward Island 24,605 20,610 83.8 20,575 18,990 92.3
Nova Scotia 78,265 72,930 93.2 295,620 272,895 92.3
New Brunswick 126,915 108,910 85.8 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Ontario 888,790 834,585 93.9 7,948,715 7,417,460 93.3
Manitoba 208,230 183,295 88.0 249,370 226,040 90.6
Saskatchewan 210,685 195,430 92.8 90,650 82,400 90.9
Alberta 302,975 281,985 93.1 6,006,525 5,580,830 92.9
British Columbia 739,200 689,360 93.3 265,480 225,700 85.0
Yukon 4,525 3,955 87.4 27,290 23,900 87.6
Northwest Territories 6,795 3,720 54.8 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Nunavut 1,690 735 43.6 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Table A.2-2
Number and percentage of DAD and NACRS records linking to the DRD, by province or territory, Canada (excluding Quebec), 2009/2010 through 2013/2014 — Part 2
Table summary
This table displays the results of Number and percentage of DAD and NACRS records linking to the DRD DAD records , DAD records linked
to DRD, NACRS records and NACRS records linked
to DRD, calculated using number and percent units of measure (appearing as column headers).
DAD records DAD records linked
to DRD
NACRS records NACRS records linked
to DRD
number number percent number number percent
Fiscal year 2012/2013
Canada (excluding Quebec) 2,718,850 2,509,485 92.3 15,641,385 14,491,755 92.7
Newfoundland and Labrador 119,110 104,750 87.9 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Prince Edward Island 23,825 19,835 83.3 20,465 18,755 91.6
Nova Scotia 76,885 71,780 93.4 293,400 271,140 92.4
New Brunswick 124,895 109,375 87.6 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Ontario 899,170 843,755 93.8 8,003,225 7,462,265 93.2
Manitoba 202,950 178,875 88.1 239,980 217,685 90.7
Saskatchewan 210,500 195,200 92.7 164,285 148,905 90.6
Alberta 306,990 285,370 93.0 6,096,535 5,643,620 92.6
British Columbia 741,790 692,100 93.3 796,030 705,355 88.6
Yukon 4,660 4,170 89.5 27,460 24,025 87.5
Northwest Territories 6,490 3,575 55.1 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Nunavut 1,590 700 44.1 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Fiscal year 2013/2014
Canada (excluding Quebec) 2,756,330 2,528,845 91.7 16,163,640 14,848,360 91.9
Newfoundland and Labrador 125,340 110,005 87.8 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Prince Edward Island 25,010 20,955 83.8 19,885 18,305 92.1
Nova Scotia 76,395 70,960 92.9 304,890 280,070 91.9
New Brunswick 123,695 107,920 87.2 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Ontario 903,945 844,505 93.4 8,038,000 7,458,245 92.8
Manitoba 200,825 176,250 87.8 226,720 201,490 88.9
Saskatchewan 213,485 196,955 92.3 159,495 142,815 89.5
Alberta 312,115 287,020 92.0 6,400,260 5,857,825 91.5
British Columbia 763,005 706,160 92.5 988,030 867,030 87.8
Yukon 4,240 3,720 87.8 26,360 22,580 85.7
Northwest Territories 6,660 3,675 55.1 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Nunavut 1,615 715 44.4 Note ...: not applicable Note ...: not applicable Note ...: not applicable
Table A.3
Number and percentage of female breast cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis, by age group and province or territory, Canada (excluding Quebec), 2010 to 2012
Table summary
This table displays the results of Number and percentage of female breast cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis 19 to 49 years, 50 to 69 years, 70 years and older, Linked CCTLP Tumour Cohort and Tumours with one or more surgical intervention, calculated using number and percent units of measure (appearing as column headers).
19 to 49 years 50 to 69 years 70 years and older
Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention
number number percent number number percent number number percent
Canada (excluding Quebec) 10,300 9,355 90.8 25,255 23,020 91.1 14,150 11,930 84.3
Newfoundland and Labrador 190 190 98.4 560 530 94.3 290 245 84.1
Prince Edward Island 40 40 97.7 180 170 94.9 100 85 87.6
Nova Scotia 405 385 95.0 1,030 970 94.4 600 500 82.6
New Brunswick 250 240 97.6 790 755 95.3 490 410 83.1
Ontario 5,530 4,890 88.3 12,930 11,550 89.3 7,165 5,915 82.5
Manitoba 430 390 90.9 1,180 1,050 89.0 710 580 81.4
Saskatchewan 295 270 91.5 915 860 94.0 665 580 86.8
Alberta 1,420 1,315 92.6 3,075 2,825 91.8 1,585 1,380 86.9
British Columbia 1,715 1,620 94.2 4,520 4,240 93.9 2,520 2,230 88.6
Yukon 10 10 83.3 30 30 90.6 15 10 69.2
Northwest Territories Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 81.3 40 35 91.9 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 71.4
Nunavut Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 80.0 10 10 100.0 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 100.0
Table A.4
Number and percentage of colorectal cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis, by age group and province or territory, Canada (excluding Quebec), 2010 to 2012
Table summary
This table displays the results of Number and percentage of colorectal cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis 19 to 49 years, 50 to 69 years, 70 years and older, Linked CCTLP Tumour Cohort and Tumours with one or more surgical intervention, calculated using number and percent units of measure (appearing as column headers).
19 to 49 years 50 to 69 years 70 years and older
Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention
number number percent number number percent number number percent
Canada (excluding Quebec) 3,235 2,710 83.7 18,750 16,305 87.0 21,270 17,415 81.9
Newfoundland and Labrador 110 100 88.9 675 625 92.6 685 565 82.3
Prince Edward Island 15 10 75.0 110 100 91.1 160 130 80.7
Nova Scotia 120 100 84.9 990 875 88.6 1,110 905 81.4
New Brunswick 10 90 87.1 670 575 86.1 720 590 82.0
Ontario 1,630 1,320 81.0 8,900 7,470 83.9 10,240 8,250 80.6
Manitoba 165 135 81.8 960 840 87.2 1,140 910 79.9
Saskatchewan 130 110 86.2 860 770 89.3 970 815 83.9
Alberta 430 370 86.0 2,285 2,040 89.4 2,275 1,835 80.7
British Columbia 520 460 88.1 3,210 2,935 91.3 3,940 3,385 86.0
Yukon Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 100.0 30 25 85.7 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 85.7
Northwest Territories 10 10 87.5 50 40 84.8 20 15 82.4
Nunavut Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 100.0 15 15 87.5 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 85.7
Table A.5
Number and percentage of prostate cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis, by age group and province or territory, Canada (excluding Quebec), 2010 to 2012
Table summary
This table displays the results of Number and percentage of prostate cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis 19 to 49 years, 50 to 69 years, 70 years and older, Linked CCTLP Tumour Cohort and Tumours with one or more surgical intervention, calculated using number and percent units of measure (appearing as column headers).
19 to 49 years 50 to 69 years 70 years and older
Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention
number number percent number number percent number number percent
Canada (excluding Quebec) 1,210 695 57.4 30,550 13,520 44.2 20,385 2,255 11.1
Newfoundland and Labrador 25 20 83.3 865 415 48.2 455 35 7.7
Prince Edward Island Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 260 60 23.1 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Nova Scotia 55 35 65.5 1,335 625 46.7 785 115 14.8
New Brunswick 45 25 52.3 1,260 415 33.1 635 45 7.2
Ontario 625 350 55.6 15,145 6,755 44.6 10,040 980 9.7
Manitoba 35 15 41.2 1,110 480 43.3 840 75 8.7
Saskatchewan 40 20 51.2 1,150 410 35.5 860 85 9.8
Alberta 245 145 59.1 4,175 1,850 44.3 2,340 330 14.2
British Columbia 130 80 63.3 5,190 2,480 47.8 4,270 580 13.5
Yukon Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 35 20 55.9 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Northwest Territories Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 20 5 31.6 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Nunavut 0 0 0.0 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Table A.6
Number and percentage of lung and bronchus cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis, by age group and province or territory, Canada (excluding Quebec), 2010 to 2012
Table summary
This table displays the results of Number and percentage of lung and bronchus cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis 19 to 49 years, 50 to 69 years, 70 years and older, Linked CCTLP Tumour Cohort and Tumours with one or more surgical intervention, calculated using number and percent units of measure (appearing as column headers).
19 to 49 years 50 to 69 years 70 years and older
Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention
number number percent number number percent number number percent
Canada (excluding Quebec) 1,615 440 27.2 21,110 4,955 23.5 25,300 3,980 15.7
Newfoundland and Labrador 30 5 22.6 600 130 19.8 600 70 11.2
Prince Edward Island 10 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 165 30 19.5 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Nova Scotia 65 20 29.2 1,155 310 26.9 1,400 205 14.7
New Brunswick 55 20 37.0 885 280 31.7 960 190 19.6
Ontario 865 235 27.1 10,480 2,455 23.4 12,375 2,075 16.7
Manitoba 75 25 32.9 1,040 290 27.6 1,245 250 20.0
Saskatchewan 60 15 23.0 875 210 23.8 1,205 160 13.5
Alberta 190 50 27.4 2,310 505 21.9 2,810 395 14.0
British Columbia 260 65 25.4 3,515 740 21.1 4,460 615 13.8
Yukon Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 30 5 20.7 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Northwest Territories Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 25 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 20 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Nunavut Note x: suppressed to meet the confidentiality requirements of the Statistics Act 0 0.0 25 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Table A.7
Number and percentage of urinary bladder cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis by age group and province or territory, Canada (excluding Quebec),
2010 to 2012
Table summary
This table displays the results of Number and percentage of urinary bladder cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis by age group and province or territory 19 to 49 years, 50 to 69 years, 70 years and older, Linked CCTLP Tumour Cohort and Tumours with one or more surgical intervention, calculated using number and percent units of measure (appearing as column headers).
19 to 49 years 50 to 69 years 70 years and older
Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention
number number percent number number percent number number percent
Canada (excluding Quebec) 580 525 90.7 5,485 5,125 93.5 8,255 7,455 90.3
Newfoundland and Labrador 10 10 90.9 165 155 95.7 195 180 93.8
Prince Edward Island Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 40 40 92.9 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Nova Scotia 25 20 95.7 345 330 95.7 440 405 91.9
New Brunswick 30 30 93.8 265 250 94.0 345 320 92.2
Ontario 215 185 85.6 2,095 1,905 91.0 3,465 3,065 88.5
Manitoba 20 15 89.5 295 270 92.5 415 360 87.4
Saskatchewan 40 35 94.7 250 240 94.5 400 370 92.3
Alberta 115 105 91.2 845 795 94.1 1,070 970 90.7
British Columbia 120 115 95.8 1,170 1,125 96.3 1,860 1,720 92.5
Yukon Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 10 10 88.9 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Northwest Territories 0 0 0.0 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Nunavut 0 0 0.0 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act
Table A.8
Number and percentage of thyroid cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis by age group and province or territory, Canada (excluding Quebec), 2010 to 2012
Table summary
This table displays the results of Number and percentage of thyroid cancer tumours diagnosed among patients aged 19 or older with at least one surgical treatment within one year of diagnosis by age group and province or territory 19 to 49 years, 50 to 69 years, 70 years and older, Linked CCTLP Tumour Cohort and Tumours with one or more surgical intervention, calculated using number and percent units of measure (appearing as column headers).
19 to 49 years 50 to 69 years 70 years and older
Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention Linked CCTLP Tumour Cohort Tumours with one or more surgical intervention
number number percent number number percent number number percent
Canada (excluding Quebec) 6,070 5,745 94.7 5,120 4,775 93.3 1,360 1,170 86.1
Newfoundland and Labrador 125 125 100.0 145 145 98.6 45 40 93.3
Prince Edward Island 10 10 100.0 15 10 80.0 5 5 100.0
Nova Scotia 140 135 96.4 160 160 98.8 55 50 92.9
New Brunswick 140 145 100.0 215 215 98.6 50 45 81.1
Ontario 4,095 3,855 94.1 3,380 3,115 92.2 830 715 86.5
Manitoba 185 170 90.9 145 140 94.6 45 40 84.4
Saskatchewan 135 135 98.5 105 100 96.2 35 30 80.0
Alberta 720 695 96.7 495 470 94.5 125 105 85.5
British Columbia 505 470 93.5 450 420 92.9 165 140 83.1
Yukon Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 0.0 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 100.0 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 100.0
Northwest Territories Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 0.0 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 100.0 0 0 0.0
Nunavut Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 0.0 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 100.0 Note x: suppressed to meet the confidentiality requirements of the Statistics Act Note x: suppressed to meet the confidentiality requirements of the Statistics Act 0.0

Appendix B – Surgical treatments for cancer primary sites

Table B.1-1
Primary site surgical treatments and CIHI intervention codes — Breast, colorectal and prostate cancers
Table summary
This table displays the results of Primary site surgical treatments and CIHI intervention codes — Breast. The information is grouped by Cancer type and physical/physiological therapeutic intervention (appearing as row headers), Intervention code (appearing as column headers).
Cancer type and physical/physiological therapeutic intervention Intervention code
Breast
Excision partial, nipple 1.YK.87.^^
Excision total, nipple 1.YK.87.^^
Excision partial, breast 1.YM.87.^^
Excision partial with reconstruction, breast 1.YM.88.^^
Excision total, breast 1.YM.89.^^
Excision total with reconstruction, breast 1.YM.90.^^
Excision radical, breast 1.YM.91.^^
Excision radical with reconstruction, breast 1.YM.92.^^
Excision partial, lymph node(s), axillary 1.MD.87.^^
Excision total, lymph node(s), axillary 1.MD.89.^^
Colorectal
Excision partial, large intestine 1.NM.87.^^
Excision total, large intestine 1.NM.89.^^
Excision radical, large intestine 1.NM.91.^^
Excision partial, rectum 1.NQ.87.^^
Excision total, rectum 1.NQ.89.^^
Excision partial, lymph node(s), pelvic 1.MH.87.^^
Excision total, lymph node(s), pelvic 1.MH.89.^^
Excision partial, lymph node(s), intra abdominal 1.MG.87.^^
Excision total, lymph node(s), intra abdominal 1.MG.89.^^
Bypass, large intestine 1.NM.76.^^
Bypass with exteriorization, large intestine 1.NM.77.^^
Reattachment, large intestine 1.NM.82.^^
Construction or reconstruction, rectum 1.NQ.84.^^
Prostate
Excision radical, prostate 1.QT.91.^^
Excision radical, bladder NEC 1.PM.91.^^
Excision radical with reconstruction, bladder NEC 1.PM.92.^^
Excision total, testis 1.QM.89.^^
Excision radical, testis 1.QM.91.^^
Destruction, prostate 1.QT.59.^^
Excision partial, lymph node(s), pelvic 1.MH.87.^^
Excision total, lymph node(s), pelvic 1.MH.89.^^
Table B.1-2
Primary site surgical treatments and CIHI intervention codes — Urinary bladder, lung and thyroid cancers
Table summary
This table displays the results of Primary site surgical treatments and CIHI intervention codes — Urinary bladder. The information is grouped by Cancer type and physical/physiological therapeutic intervention (appearing as row headers), Intervention code (appearing as column headers).
Cancer type and physical/physiological therapeutic intervention Intervention code
Urinary bladder
Excision partial, bladder neck 1.PL.87.^^
Excision partial, bladder 1.PM.87.^^
Excision total, bladder 1.PM.89.^^
Excision total with reconstruction, bladder 1.PM.90.^^
Excision radical, bladder 1.PM.91.^^
Excision radical with reconstruction, bladder 1.PM.92.^^
Destruction, bladder 1.PM.59.^^
Excision partial, lymph node(s), pelvic 1.MH.87.^^
Excision total, lymph node(s), pelvic 1.MH.89.^^
Lung
Excision partial, lobe of lung 1.GR.87.^^
Excision total, lobe of lung 1.GR.89.^^
Excision radical, lobe of lung 1.GR.91.^^
Excision partial, lung NEC 1.GT.87.^^
Excision total, lung NEC 1.GT.89.^^
Excision radical, lung NEC 1.GT.91.^^
Excision radical with reconstruction, carina 1.GN.92.^^
Excision partial, lymph node(s), mediastinal 1.ME.87.^^
Excision total, lymph node(s), mediastinal 1.ME.89.^^
Excision partial, lymph node(s), intrathoracic NEC 1.MF.87.^^
Excision partial, lymph node(s), cervical 1.MC.87.^^
Excision total, lymph node(s), cervical 1.MC.89.^^
Excision radical, lymph node(s), cervical 1.MC.91.^^
Thyroid
Excision partial, thyroid gland 1.FU.87^^
Excision total, thyroid gland 1.FU.89^^
Excision total, parathyroid gland 1.FV.89.^^
Excision radical, larynx NEC 1.GE.91.^^
Excision partial, mediastinum 1.GW.87.^^
Excision partial, lymph node(s), mediastinal 1.ME.87.^^
Excision total, lymph node(s), mediastinal 1.ME.89.^^
Excision partial, lymph node(s), deep cervical 1.MB.87.^^
Excision partial, lymph node(s), cervical 1.MC.87.^^
Excision total, lymph node(s), cervical 1.MC.89.^^
Excision radical, lymph node(s), cervical 1.MC.91.^^
Excision partial, intrathoracic lymph nodes 1.MF.87.^^

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