Analysis of tumour stage and treatment 26 REGISTRIES IN TOTAL –2: BREAST ONLY –2: CHILDREN ONLY DATE OF INCIDENCE RANGE: YEARS OF DATA RANGE: 2 TO 25 REGISTRIES VARY IN SIZE (NUMBER OF CASES) AND YEAR RANGE OF DATA

Stage and treatment data fields Method of diagnosis:histology, cytology, either, none or unknown Actual T, N and M data:detailed information on T, N and M status Condensed T, N and M:(more generalised information) T: localised or advanced N: none or present M: none or present Stage (Extent of Disease)combined information on tumour, nodal & distant metastasis in a single value. * possible to assign cases as local, regional or distant Tumour size in millimetres Number of nodes examined & number with metastasis Certainty factor:if specialised diagnostic methods were used in order to stage Treatmentsurgery, chemotherapy, radiotherapy, other therapies (such as hormonal therapy) indicated (yes, no, unknown) Treatment flagged as first therapy post-diagnosis and/or symptomatic treatment

Data available on stage and treatment

Entities examined for stage and treatment: Digestive cancers:Oesophagus Stomach Small Intestine Colon, Rectum, Anal Canal Pancreas Liver and Intrahepatic Bile Ducts Gall-bladder and Extrahepatic Bile Ducts Lung cancer Breast cancer Prostate cancer

Breast cancer: breakdown by sub-entity

Metaplastic breast carcinoma: breakdown by Registry

Lung cancer: breakdown by sub-entity

Large cell carcinoma of lung: breakdown by Registry

Colon cancer: Tumour T Stage validity* *codes judged invalid if they do not conform to AJCC staging protocol (Edition 1-6) Valid codes: 0, 1, 2 (2A,2B [2nd ed AJCC]), 3, 4, 5 ([1st ed AJCC])

Colon cancer: Distribution of tumour T stage Average (all registries excl Ireland & Zurich): T1=7%, T2=15%, T3=60%, T4=18%)

Breast cancer: Distribution of tumour T stage Average (all registries excl Ireland): T1=52%, T2=35%, T3=5%, T4=8%)

Colon cancer: Tumour N Stage validity* *codes judged invalid if they do not conform to AJCC staging protocol (Edition 1-6) Valid codes: 0, 1, 2, 3

Colon cancer: Distribution of tumour N stage Average (all registries excl Slovenia Cracow, Zurich, Ireland): N0=54%, N1=30%, N2=13%, N3=3%)

Colon cancer: Distribution of tumour M stage Average all registries: M0=71%, M1=29%

Colon cancer: Distribution of tumour M stage

Summary stage (extent of disease) 1: Tumour confined to site of origin 2: Tumour has spread to immediately adjacent tissues and /or regional lymph nodes 3: Tumour has spread to distant organs 4: Tumour not confined to site of origin but not specified whether code 2 or 3 applies 5: No distant metastasis but not specified whether code 1 or 2 applies Codes can be grouped to define a tumour as: Local (code 1) Regional (code 5+2) Distant (code 4+3) ORDER:

Stage (Extent of disease) for Breast cancer

Stages separately

Stage (Extent of disease) for Breast cancer Grouped stages

Comparison of Stage 1 (tumour confined to site of origin) and TNM data (T=any, N=0, M=0) Breast cancer

Comparison of Stage 3 (tumour spread to distant organs) and M=1 (positive M stage) data Breast cancer

Stage (Extent of disease) for Prostate cancer

Breast cancer: Registries where lymph node status was examined

Breast cancer: tumour size

Registries that provided treatment information and years of data available common to all Basque, EAnglia, WestMidlands: Codes = Yes - Unknown All Other registries: Codes = Yes - No - Unknown

1996 – 1999 Lung cancer treatment

Lung cancer cases having had surgery Yorkshire: 200 cases not microscopically confirmed

Pancreas cancer cases having had surgery EAnglia: 368 cases not microscopically confirmed

Colon Cancer: Surgery