Definition: The percentage of patients diagnosed with stage III colon cancer who received chemotherapy following resection
Numerator: Stage III colon cancer cases that had a resection within one year of diagnosis and started post-operative chemotherapy within 120 days of resection
Denominator: Stage III colon cancer cases having a colon resection within one year of diagnosis
Data source: Provincial cancer agencies
Measurement timeframe: 2009, 2010, 2011 and 2012 diagnosis years
Stratification variables: Province, age, sex
Provinces submitting data: AB, SK, MB, PE, NL
AB: For 2009, data did not limited to complete resections (colectomy). For 2010/2011/2012, treatment information is based on initially planned treatment to primary site (ACR data). The CCI codes are not identified in the ACR, as such all coded surgeries were included for complete rectum resection. If more than one surgical procedure is performed, the ACR codes the most definitive procedures is documented. The definition of definitive is the surgical procedure with the intent to cure. There are some procedures could not identify the margins are negative. For 2011/2012, through quality assurance, there are a number of cases coded as surgery on the ACR had CCI codes or Billing codes other than the ones listed. The majority of these cases appear to be cases in which the DAD had resection of the rectum even though the patient only had C18.7 sigmoid colon. There are also some cases in which the ACR codes surgery for colon but no records were found in the Inpatient database or Billing data. This may be out of province resection. Cases with chemotherapy before surgery were excluded.
SK: For 2012, data were not limited to complete resections where margins are negative.
MB: For 2009, oral drugs given at Cancer Care Manitoba are included. However, patients who received oral chemotherapy through prescription may be missed in the reported data. For 2010/2011/2012, data were not limited to complete resections where margins are negative, oral systemic therapy included if available but may not be complete.
PE: Treatment intent filter was used to identify adjuvant therapy for 2009. But it was not applied for 2010 data as it was only entered part way through the year so data is missing for half of the applicable cases. For 2010/2011, data were not limited to complete resection where margins are negative.
NL: For 2009/2010, treatment intent filter was used to identify adjuvant therapy. For 2010, cases where margin status was positive or unknown were removed from the denominator. All cases that did not have an eligible surgery as per Procedure Codes table were removed from the denominator. In many cases, data were available for the date on which a chemotherapy script was written but not a definitive start date.
Colon cases defined as ICDO3 codes: C18.0-C18.9 for 2009, C18.0 and C18.2 to C18.9 for 2010/ 2011/2012, AJCC group stage at diagnosis = III.
Excluded lymphoma codes M-95 to M-98. For 2010/2011/2012, data also excluded sarcoma codes (see Appendix 1), neuroendocrine carcinoma, squamous cell carcinoma.
Cases for patients under 18 years of age (at diagnosis) were excluded.
Colon resection identified using CCI codes 1NM87 or 1NM89 or 1NM91 or list of descriptors in Appendix 1.
Resected cases included regardless of margin status (due to data limitations) for 2009, included margins are negative for 2010/2011/2012.
Chemotherapy includes oral and IV chemotherapy.
Included cases which last resection date (if multiple)-diagnosis date <=365 days. Chemotherapy start date-last resection date (if multiple) <=120 days
No filter for treatment intent was used, unless otherwise specified by province for 2009.