Identifying skeletal-related events for prostate cancer patients in routinely collected hospital data.

Non-osteoporotic skeletal-related events (SREs) are clinically important markers of disease progression in prostate cancer. We developed and validated an approach to identify SREs in men with prostate cancer using routinely-collected data.

Patients diagnosed with prostate cancer between January 2010 and December 2013 were identified in the National Prostate Cancer Audit, based on English cancer registry data. A coding framework was developed based on diagnostic and procedure codes in linked national administrative hospital and routinely-collected radiotherapy data to identify SREs occurring before December 2015. Two coding definitions of SREs were assessed based on whether the SRE codes were paired with a bone metastasis code ('specific definition') or used in isolation ('sensitive definition'). We explored the validity of both definitions by comparing the cumulative incidence of SREs from time of diagnosis according to prostate cancer stage at diagnosis with death as a competing risk.

We identified 40,063, 25,234 and 13,968 patients diagnosed with localised, locally advanced and metastatic disease, respectively. Using the specific definition, we found that the 5-year cumulative incidence of SREs was 1.0 % in patients with localised disease, 6.0 % in patients with locally advanced disease, and 42.3 % in patients with metastatic disease. Using the sensitive definition, the corresponding cumulative incidence figures were 9.0 %, 14.9 %, and 44.4 %, respectively.

The comparison of the cumulative incidence of SREs identified in routinely collected hospital data, based on a specific coding definition in patients diagnosed with different prostate cancer stage, supports their validity as a clinically important marker of cancer progression.

Cancer epidemiology. 2019 Nov 09 [Epub]

Matthew G Parry, Thomas E Cowling, Arunan Sujenthiran, Julie Nossiter, Brendan Berry, Paul Cathcart, Noel W Clarke, Heather Payne, Ajay Aggarwal, Jan van der Meulen

Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, United Kingdom; Clinical Effectiveness Unit, The Royal College of Surgeons of England, United Kingdom. Electronic address: ., Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, United Kingdom. Electronic address: ., Clinical Effectiveness Unit, The Royal College of Surgeons of England, United Kingdom. Electronic address: ., Clinical Effectiveness Unit, The Royal College of Surgeons of England, United Kingdom. Electronic address: ., Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, United Kingdom; Clinical Effectiveness Unit, The Royal College of Surgeons of England, United Kingdom. Electronic address: ., Department of Urology, Guy's and St Thomas' NHS Foundation Trust, United Kingdom. Electronic address: ., Department of Urology, The Christie NHS Foundation Trust Manchester, United Kingdom; Department of Urology, Salford Royal NHS Foundation Trust, United Kingdom. Electronic address: ., Department of Oncology, University College London Hospitals, United Kingdom. Electronic address: ., Department of Cancer Epidemiology, Population, and Global Health, King's College London, United Kingdom; Department of Radiotherapy, Guy's and St Thomas' NHS Foundation Trust, United Kingdom. Electronic address: ., Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, United Kingdom. Electronic address: .