Exploring barriers and facilitators to capturing cancer stage at diagnosis in a population-based cancer registry: a cross-sectional survey of health information managers/clinical coders and multidisciplinary team members

Abstract Background Cancer stage is important to capture within population-based cancer registries (PBCRs) to facilitate recruitment to clinical trials, evaluate prevention programs, assess treatment impact, and forecast cancer service needs. However, capture of cancer stage at diagnosis in many PBC...

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Main Authors: Laura Woodings, Kris Ivanova, Linda Nolte, Kathryn Baxter, Carla Read, Fiona Kennett, Patsy Catterson, Kerry Davidson, Colin Hornby, Vivian Yang, Jodie Lydeker, Luc te Marvelde, Belinda Yeo, Sue M. Evans
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-025-12564-5
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author Laura Woodings
Kris Ivanova
Linda Nolte
Kathryn Baxter
Carla Read
Fiona Kennett
Patsy Catterson
Kerry Davidson
Colin Hornby
Vivian Yang
Jodie Lydeker
Luc te Marvelde
Belinda Yeo
Sue M. Evans
author_facet Laura Woodings
Kris Ivanova
Linda Nolte
Kathryn Baxter
Carla Read
Fiona Kennett
Patsy Catterson
Kerry Davidson
Colin Hornby
Vivian Yang
Jodie Lydeker
Luc te Marvelde
Belinda Yeo
Sue M. Evans
author_sort Laura Woodings
collection DOAJ
description Abstract Background Cancer stage is important to capture within population-based cancer registries (PBCRs) to facilitate recruitment to clinical trials, evaluate prevention programs, assess treatment impact, and forecast cancer service needs. However, capture of cancer stage at diagnosis in many PBCRs is low, stemming from missing data in cancer registrations from health services. This study aims to identify the barriers and facilitators faced by Health Information Managers (HIM)/Clinical Coders (CC) and key multidisciplinary team meeting (MDM) personnel when capturing cancer stage at diagnosis. Method A cross-sectional online survey was conducted with 167 HIM/CC and 58 key MDM personnel employed within Victorian hospitals. The survey included 8 descriptor questions, 12–14 5-point Likert questions and 2–3 free text questions. Free text questions were analysed using the Theoretical Domains Framework, while all other questions were analysed using descriptive statistics, Spearman rank or Kruskall-Wallis tests. Results For HIM/CC, barriers related to the theoretical domains of (i) environmental context and resources, with 87% of participants agreeing required information was not readily available, (ii) knowledge, with 46% of participants agreeing they worry about incorrectly coding stage and (iii) skills, with 42% of participants agreeing they were not confident and 37% feeling they had inadequate training. For key MDM personnel, barriers related to the theoretical domains of (i) environmental context and resources, with 50% of participants agreeing there were time constraints, and required information was not readily available (ii) goals, with 36% of participants agreeing capturing cancer stage is not a priority, and (iii) social/professional role and identity, with 36% of participants agreeing it was not their role to discuss and capture stage. Despite the barriers, over half of participants in both groups agreed recording stage at diagnosis was a vital task. Conclusions Resolving the barriers identified will require enhancing documentation available to, and the training received by, HIM/CC and encouraging MDM Chairs to ensure cancer stage is discussed and recorded adequately for all patients presented.
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spelling doaj-art-0cd7b46cd59a4aacb63037382d18af852025-08-20T02:10:49ZengBMCBMC Health Services Research1472-69632025-04-0125111010.1186/s12913-025-12564-5Exploring barriers and facilitators to capturing cancer stage at diagnosis in a population-based cancer registry: a cross-sectional survey of health information managers/clinical coders and multidisciplinary team membersLaura Woodings0Kris Ivanova1Linda Nolte2Kathryn Baxter3Carla Read4Fiona Kennett5Patsy Catterson6Kerry Davidson7Colin Hornby8Vivian Yang9Jodie Lydeker10Luc te Marvelde11Belinda Yeo12Sue M. Evans13Cancer Council VictoriaCancer Council VictoriaNorth Eastern Melbourne Integrated Cancer ServicePeter MacCallum Cancer CentreVictorian Department of HealthCancer Council VictoriaGrampians Integrated Cancer ServiceGrampians Integrated Cancer ServiceVictorian Department of HealthCancer Council VictoriaBreast Cancer Network AustraliaCancer Council VictoriaAustin HospitalCancer Council VictoriaAbstract Background Cancer stage is important to capture within population-based cancer registries (PBCRs) to facilitate recruitment to clinical trials, evaluate prevention programs, assess treatment impact, and forecast cancer service needs. However, capture of cancer stage at diagnosis in many PBCRs is low, stemming from missing data in cancer registrations from health services. This study aims to identify the barriers and facilitators faced by Health Information Managers (HIM)/Clinical Coders (CC) and key multidisciplinary team meeting (MDM) personnel when capturing cancer stage at diagnosis. Method A cross-sectional online survey was conducted with 167 HIM/CC and 58 key MDM personnel employed within Victorian hospitals. The survey included 8 descriptor questions, 12–14 5-point Likert questions and 2–3 free text questions. Free text questions were analysed using the Theoretical Domains Framework, while all other questions were analysed using descriptive statistics, Spearman rank or Kruskall-Wallis tests. Results For HIM/CC, barriers related to the theoretical domains of (i) environmental context and resources, with 87% of participants agreeing required information was not readily available, (ii) knowledge, with 46% of participants agreeing they worry about incorrectly coding stage and (iii) skills, with 42% of participants agreeing they were not confident and 37% feeling they had inadequate training. For key MDM personnel, barriers related to the theoretical domains of (i) environmental context and resources, with 50% of participants agreeing there were time constraints, and required information was not readily available (ii) goals, with 36% of participants agreeing capturing cancer stage is not a priority, and (iii) social/professional role and identity, with 36% of participants agreeing it was not their role to discuss and capture stage. Despite the barriers, over half of participants in both groups agreed recording stage at diagnosis was a vital task. Conclusions Resolving the barriers identified will require enhancing documentation available to, and the training received by, HIM/CC and encouraging MDM Chairs to ensure cancer stage is discussed and recorded adequately for all patients presented.https://doi.org/10.1186/s12913-025-12564-5Population-based cancer registryCancer stageSurveyMultidisciplinary team meetings
spellingShingle Laura Woodings
Kris Ivanova
Linda Nolte
Kathryn Baxter
Carla Read
Fiona Kennett
Patsy Catterson
Kerry Davidson
Colin Hornby
Vivian Yang
Jodie Lydeker
Luc te Marvelde
Belinda Yeo
Sue M. Evans
Exploring barriers and facilitators to capturing cancer stage at diagnosis in a population-based cancer registry: a cross-sectional survey of health information managers/clinical coders and multidisciplinary team members
BMC Health Services Research
Population-based cancer registry
Cancer stage
Survey
Multidisciplinary team meetings
title Exploring barriers and facilitators to capturing cancer stage at diagnosis in a population-based cancer registry: a cross-sectional survey of health information managers/clinical coders and multidisciplinary team members
title_full Exploring barriers and facilitators to capturing cancer stage at diagnosis in a population-based cancer registry: a cross-sectional survey of health information managers/clinical coders and multidisciplinary team members
title_fullStr Exploring barriers and facilitators to capturing cancer stage at diagnosis in a population-based cancer registry: a cross-sectional survey of health information managers/clinical coders and multidisciplinary team members
title_full_unstemmed Exploring barriers and facilitators to capturing cancer stage at diagnosis in a population-based cancer registry: a cross-sectional survey of health information managers/clinical coders and multidisciplinary team members
title_short Exploring barriers and facilitators to capturing cancer stage at diagnosis in a population-based cancer registry: a cross-sectional survey of health information managers/clinical coders and multidisciplinary team members
title_sort exploring barriers and facilitators to capturing cancer stage at diagnosis in a population based cancer registry a cross sectional survey of health information managers clinical coders and multidisciplinary team members
topic Population-based cancer registry
Cancer stage
Survey
Multidisciplinary team meetings
url https://doi.org/10.1186/s12913-025-12564-5
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