Providing population-based evidence for improving cancer outcomes for all patients using routinely collected linked data

Researchers within the Cancer Survival Group perform solely observational research for evaluating the role of diagnostic pathways and access to healthcare upon patterns and inequalities in cancer survival. Our overall aim is to provide population-based evidence for improving cancer outcomes for all patients.

Our research is based on the analysis of linked electronic health records, mostly provided by the National Cancer Registration and Analysis Service (NCRAS) run by Public Health England (PHE). Depending on the research aim, these data may include various datasets linked to the National Cancer Registry, such as Hospital Episode Statistics, various clinical cancer audit datasets and/or the Clinical Practice Research Datalink (CPRD). We hold anonymous individual data for our research which is covered by the ethical and statutory approvals 13-LO-0610, PIAG 3-06(f) 2008, 08/H1102/46. (for more details, see here). The data are handled according to our NHS approved Information Governance Toolkit and corresponding CSG – System Level Security Policy.

The data we receive from PHE are subject to rights under the General Data Protection Regulation (GDPR) – see for additional information https://www.gov.uk/guidance/national-cancer-registration-and-analysis-service-ncras and https://www.cprd.com/transparency-information.


Research using NCRAS linked to CPRD

The analysis of primary care data from the CPRD linked to NCRAS led to publications in international journals and presentations at conferences. The publications have been widely cited and have attracted substantial media attention, having been covered by The Guardian, BBC News, The Times, The Daily Telegraph, Cancer Research UK and others.

Our projects focus in particular on the analysis of patterns of symptomatic presentations in primary care prior to diagnosis as well as the risk of emergency cancer diagnosis, evaluating the specific contributions of tumour, patient and healthcare factors in influencing diagnostic pathways, timely cancer diagnosis and cancer survival, and how these vary between different sub-populations.

We have established close collaborations with other research institutions including University College London (UCL), University of Exeter Medical School, University of Cambridge, University of Nottingham and University of Hull (Hull York Medical School).


Selected publications using CPRD data

Do colorectal cancer patients diagnosed as an emergency differ from non-emergency patients in their consultation patterns and symptoms?  A longitudinal data-linkage study in England. BJC
Renzi C, Lyratzopoulos G, Card T, Chu T, Macleod U, Rachet B. 


Do pre-diagnosis primary care consultation patterns explain deprivation-specific differences in net survival among women with breast cancer? An examination of individually-linked data from the UK West Midlands cancer registry, national screening programme and Clinical Practice Research Datalink. BMC cancer, 17. p. 11. ISSN 1471-2407
Morris, M; Woods, LM; Bhaskaran, K; Rachet, B; (2017)


Pattern of symptoms and signs of primary intracranial tumours in children and young adults: a record linkage study.  Archives of disease in childhood. 2015; 100(12):1115-22.
Chu TP, Shah A, Walker D, Coleman MP.


Where are the opportunities for an earlier diagnosis of primary intracranial tumours in children and young adults?
Chu TPC, Shah A, Walker D, Coleman MP

Where are the opportunities for an earlier diagnosis of primary intracranial tumours in children and young adults?


How Do Biological Characteristics of Primary Intracranial Tumors Affect Their Clinical Presentation in Children and Young Adults?
Thomas P. C. Chu, Anjali Shah, David Walker, Michel P. Coleman


Selected oral presentations at conferences using CPRD data

Morris, M; Rachet, B; Woods, L;  A preliminary examination of linked data from the West Midlands breast cancer registry, breast screening programme and primary care.(2015)


Renzi C, Lyratzopoulos G, Hamilton W, Maringe C, Rachet B. Effects of comorbidities on primary care consultations with cancer symptoms and emergency colon cancer diagnosis: A longitudinal data-linkage study in England. Public Health England-PHE Cancer Services, Data and Outcomes Conference, Manchester 20-21 June 2018.


Renzi C, Lyratzopoulos G, Rachet B. Variations of primary care consultations and symptoms by socio-demographic patient characteristics and impact on emergency colorectal cancer diagnosis: A longitudinal data-linkage study in England. 10th Annual Meeting of the Cancer and Primary Care Research International (Ca-PRI) Network, Edinburgh, 18th–20th April 2017.


Renzi C, Lyratzopoulos G, Chu T, Rachet B. Patterns of symptomatic presentation in primary care prior to emergency and non-emergency colorectal cancer diagnosis. Cancer and Primary care conference (Ca-Pri), 26 Apr 2016, Boston, USA.


Morris, M; Woods LM; Bhaskaran K; Rachet B  Do pre-diagnosis primary care consultation patterns explain deprivation-related differences in net survival among women with breast cancer? (2016)