​Kidney Cancer Quality Performance Indicators

Overview:

Over 13,000 people are diagnosed with kidney cancer in the UK annually and the incidence has increased by 36% over the last decade [CRUK data for 2017] now being the seventh commonest cancer. Surgery (radical or partial nephrectomy) remains the standard of care in the UK for patients with disease localised to the kidney. However, many patients have significant comorbidities making them unfit for or at high risk of complications from surgery. In addition, diagnosis is often late, 23% of patients presenting as an emergency. One third of patients have metastatic cancer at presentation, of whom over 80% will have died within 5 years. There is no screening programme for kidney cancer.

Outcomes from kidney cancer services appear to vary considerably across England. However, there are no quality performance indicators (QPIs) and no NICE guidelines specifically for kidney cancer management.

The aim of this project is to provide information on the current status of kidney cancer diagnosis and treatments in England and develop a set of QPIs. The ultimate goal is to reduce variation in care and improve overall performance of services and outcomes for patients.

In collaboration with:

This work was commissioned by the Kidney Cancer UK Accord, a group comprising a patient and carer, clinical, medical and surgical oncologists, and specialist nurses brought together under the auspices of Kidney Cancer UK, the major charity dedicated to kidney cancer in the UK.

Timeframe:

Report to KCUK mid-2022
Additional analyses late 2022

Outcomes:

Analyses undertaken by HDI were recently reported in the ‘Kidney Cancer UK Quality Performance Audit of kidney cancer services in England’,  published by the UK Kidney Cancer Accord in June 2022.

https://www.kcuk.org.uk/kidney-cancer-uk-accord-audit-report/

In partnership with the National Disease Registration Service (NDRS) at NHS Digital, HDI analysed two years of kidney cancer data, examining variation in treatments (surgery and chemotherapy), clinical trial participation and mortality.

The results showed variation in treatment and clinical trial participation by Cancer Alliance and NHS trust. The full report can be found here.

Since publication of the report, the National Cancer Programme within NHS England have provided their support to the Accord’s request for the establishment of the first National Institute for Health and Care Excellence (NICE) guideline and quality standard for kidney cancer. This means that NICE will now be commissioned to carry out this work.

The hope is that the production of the guideline and standard by NICE will reduce variation and improve outcomes for kidney cancer patients.

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