Testicular Cancer: Improving Outcomes with National Quality Performance Indicators - Beyond the Abstract

Delays in a patient pathway either at diagnosis or in treatment can adversely affect the outcome in testicular germ cell cancer.1,2 It is therefore vital to be able to identify systematic pathway issues and to address them. We describe a process of national collaboration to establish a set of tumor-specific quality performance indicators (QPIs). Data submitted centrally on an annual basis has facilitated a drive towards improvement in care for testicular germ cell cancer patients on a national level.

The main strength of this project is the breadth of data collated. We are able to create outputs across a range of data fields on a macroscopic (national or regional) or microscopic (individual hospital) level. This provides a platform for research and quality improvement. There is a strong focus on learning – regions that are performing less well in a particular QPI can work with other regions to improve. An annual meeting of clinicians and healthcare managers acts as the forum to facilitate this discussion, enabling prompt change in practice.
We believe Scotland is the first country to do this on a national level. The model we describe is also used in other tumor groups within Scotland and we hope other networks/countries can learn and apply similar methodology.

Written by: Mark Baxter, MBBChir, MRCP(UK), PgCert, SCREDS Clinical Lecturer, University of Dundee, Ninewells Hospital, Dundee, Scotland, UK; Jeff White, MBChB, DM, MRCP(UK), University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, Scotland, UK


  1. Peckham, M. J., RT D. OLIVER, WG JONES, S. KAYE, and JS MACDONALD. "Prognostic factors in advanced non-seminomatous germ-cell testicular tumours: results of a multicentre study." Lancet (British edition) 8419 (1985): 8-11.
  2. Thornhill, J. A., J. J. Fennelly, D. G. Kelly, A. Walsh, and J. M. Fitzpatrick. "Patients' delay in the presentation of testis cancer in Ireland." British journal of urology 59, no. 5 (1987): 447-451.
Read the Abstract