Conclusions

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The addition of treatment information to the CCR through record linkage to the DAD/NACRS is feasible, with noted limitations. In the four provinces examined in this study, high, unbiased percentages of female breast, colorectal and prostate cancer tumours were eligible for linkage to the DAD/NACRS using direct or indirect linkage. Linkage rates to hospitalizations varied by cancer type, but generally exceeded acceptable linkage rates. Linkage rates between tumours and hospitalizations were consistently high for female breast and colorectal cancer; rates were lower for prostate cancer. The feasibility of linking tumours to treatment depended on the type of treatment. The results, which reflect the degree of national standardization in data collection,systems, demonstrate that surgical information is most consistently available through linkage.

Non-surgical treatments, such as radiation, systemic pharmacotherapy and diagnostic interventions (even surgical ones), are significantly under-reported based only on linkage to the DAD/NACRS; the results are somewhat more inclusive if linkages to the DAD via HINs are performed nationally, and if linkages include the NACRS.

The linkages in the current study provide new treatment information and validate methods that increase the analytical capacity of the CCR. These methods can be used to obtain surgical treatment information to add to the CCR. Stakeholders at the provincial, territorial and national levels can use these treatment data to investigate outcomes and wait times, for surveillance, to monitor system performance, and for resource planning.

Future development could include improvements to the comprehensiveness of captured treatments through linkage to the NACRS from other provinces.