title: Cancer-related hospitalisations and 'unknown' stage prostate cancer: a population-based record linkage study.
abstract: To identify reasons for prostate cancer stage being recorded as 'unknown' in Australia's largest population-based cancer registry.
  
  
  
  Prospective population-based cohort.
  
  
  
  New South Wales (NSW) is the most populous state in Australia, with almost one third of the total national population.
  
  
  
  NSW Cancer Registry (NSWCR) records for prostate cancer cases diagnosed in 2001-2009 were linked to the NSW Admitted Patient Data Collection (APDC) for 2000-2010. All patients in this study had a minimum of 12 months follow-up in the hospital episode records after their date of diagnosis as recorded by the NSWCR.
  
  
  
  Incidence of 'unknown' stage prostate cancer and cancer-specific survival.
  
  
  
  Of 50 597 prostate cancer cases, 39.9% were recorded as having 'unknown' stage. Up to 4 months after diagnosis, 77.2% of cases without a hospital-reported cancer diagnosis were recorded as having 'unknown' stage. Among those patients with a hospital-reported cancer diagnosis, stage was 'unknown' for 7.6% of cases who received a radical prostatectomy (RP) and for 34.0% of cases who had procedures other than RP. In the latter group, the factors that were related to having 'unknown' stage were living in disadvantaged areas (adjusted OR (aOR) range: 1.13 to 1.20), attending a private hospital (aOR range: 1.25 to 2.13), having day-only admission for care (aOR=1.23, 95% CI 1.11 to 1.36), or having procedures other than multiple procedures with imaging (eg, biopsy only, aOR range: 1.11 to 1.45).
  
  
  
  Over half of 'unknown' stage prostate cancer cases did not have a hospital-reported prostate cancer diagnosis within the 4 months after initial diagnosis. We identified differences in the likelihood of cases being recorded as 'unknown' stage based on socioeconomic status and facility type, which suggests that further investigation of reporting practices in relation to diagnostic and treatment pathways is required.
authors.affiliation: Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia.|Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Qingwei
authors.identifier: 0000-0002-8902-6869
authors.initials: Q
authors.lastname: Luo
authors.affiliation: Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia.|Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Xue Qin
authors.initials: XQ
authors.lastname: Yu
authors.affiliation: Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia.|Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.|Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: David Paul
authors.initials: DP
authors.lastname: Smith
authors.affiliation: Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia.
authors.forename: David Eamon
authors.initials: DE
authors.lastname: Goldsbury
authors.affiliation: New South Wales Cancer Registry, Cancer Institute NSW, Sydney, New South Wales, Australia.
authors.forename: Claire
authors.initials: C
authors.lastname: Cooke-Yarborough
authors.affiliation: Discipline of Surgery, University of Sydney, Sydney, New South Wales, Australia.|Department of Urology, Westmead Hospital, Westmead, New South Wales, Australia.
authors.forename: Manish Indravadan
authors.initials: MI
authors.lastname: Patel
authors.affiliation: Cancer Research Division, Cancer Council NSW, Sydney, New South Wales, Australia.|Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.|School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Dianne Lesley
authors.initials: DL
authors.lastname: O'Connell
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016247:Information Storage and Retrieval; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D009517:New South Wales / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000453:epidemiology*; D012042:Registries
keywords: data linkage; health service; population-based cancer registry; prostate cancer; socio-economic status; unknown stage at diagnosis