National Cancer Database May Underestimate the Burden of Sarcomas

Due to inconsistencies in the use of World Health Organization (WHO) disease coding, hospitals may underestimate the overall burden of sarcoma compared with other cancer types, according to an oral presentation at the Connective Tissue Oncology Society (CTOS) 2017 Annual Meeting.¹

Institutional policies determine whether cancers are coded by disease type or organ site, which can lead to miscalculations of the global burden of a particular cancer type. For this study, researchers attempted “to characterize inaccuracies and errors in sarcoma coding practices resulting in incorrect sarcoma surgical diagnostic codes and tumor registry data at a single institution.”

Data from patients treated by 1 of 5 surgeons (3 surgical oncologists, 2 orthopedic oncologists) were evaluated. WHO coding was compared with the according pathology report.

Of 1237 pathologically confirmed sarcoma cases treated between January 2012 and December 2016, only 764 (63%) were coded as sarcomas; 180 (16%) and 260 (22%) were coded as non-cancers and by organ site, respectively. Over half of breast angiosarcomas were coded as breast cancers and nearly half of gastrointestinal stromal tumors (GISTs) were coded incorrectly.

The researchers concluded that, if these results generalize to other institutions, data from the National Cancer Database, which relies on institutional reporting, could be misleading about the burden of sarcomas in the United States. Confirmation studies are needed.

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Reference

1. Lyu H, Stein LA, Saadat LV, et al. INACCURACY in sarcoma case coding: underestimation of the burden of sarcoma within a single institution. Oral presentation at: Connective Tissue Oncology Society (CTOS) 2017 Annual Meeting. November 8-11, 2017; Maui, Hawaii.