Determining cancer stage at diagnosis in population-based cancer registries: A rapid scoping review

Population-based cancer registries are the main source of data for population-level analysis of cancer stage at diagnosis. This data enables analysis of cancer burden by stage, evaluation of screening programs and provides insight into differences in cancer outcomes. The lack of standardised collection of cancer staging in Australia is well recognised and is not routinely collected within the Western Australia Cancer Registry. This review aimed to explore how cancer stage at diagnosis is determined in population-based cancer registries.

This review was guided by the Joanna-Briggs Institute methodology. A systematic search of peer-reviewed research studies and grey literature from 2000 to 2021 was conducted in December 2021. Literature was included if peer-reviewed articles or grey literature sources used population-based cancer stage at diagnosis, and were published in English between 2000 and 2021. Literature was excluded if they were reviews or only the abstract was available. Database results were screened by title and abstract using Research Screener. Full-texts were screened using Rayyan. Included literature were analysed using thematic analysis and managed through NVivo.

The findings of the 23 included articles published between 2002 and 2021 consisted of two themes. (1) "Data sources and collection processes" outlines the data sources used, as well as the processes and timing of data collection utilised by population-based cancer registries. (2) "Staging classification systems" reveals the staging classification systems employed or developed for population-based cancer staging, including the American Joint Committee on Cancer's Tumour Node Metastasis and related systems; simplified systems classified into localised, regional, and distant categories; and miscellaneous systems.

Differences in approaches used to determine population-based cancer stage at diagnosis challenge attempts to make interjurisdictional and international comparisons. Barriers to collecting population-based stage at diagnosis include resource availability, infrastructure differences, methodological complexity, interest variations, and differences in population-based roles and emphases. Even within countries, disparate funding sources and funder interests can challenge the uniformity of population-based cancer registry staging practices. International guidelines to guide cancer registries in collecting population-based cancer stage is needed. A tiered framework of standardising collection is recommended. The results will inform integrating population-based cancer staging into the Western Australian Cancer Registry.