The Welsh Cancer Intelligence & Surveillance Unit (WCISU) is the National Cancer Registry for Wales and its primary role is to record, store and report on all incidence of cancer for the resident population of Wales wherever they are treated.

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The Welsh Cancer Intelligence & Surveillance Unit (WCISU) is the National Cancer Registry for Wales and its primary role is to record, store and report on all incidence of cancer for the resident population of Wales wherever they are treated. Cancer registration in Wales began almost five decades ago and today’s electronic database which holds records going back to 1972 contains in the region of 686,000 records.

WCISU collects data about occurrences of cancer in Welsh residents via direct or indirect submissions from Welsh Hospitals.

Staging of malignant melanoma (ICD 10 code C43), breast (C50), colorectal (C18-C20) and cervix (C53) started in 2001 since this was when we started receiving pathological information. Staging for all other cancers started in 2010.

Treatment information started in 1995.

HDR UK

Welsh Cancer Intelligence & Surveillance Unit (WCISU) which is a part of Public Health Wales (PHW)

DIAG_HOSP

Details of a new and abnormal growth of tissue in a part of the body, i.e. embodies characteristics of cancer. Contains details on staging, diagnoses, and grade of neoplasm. Data available from approximately 1980 [will differ for various tables].

neoplasm

DIAG_HOSP_NAME

DIAG_TRUST

DIAG_TRUST_NAME

FIRST_HOSP

FIRST_HOSP_NAME

FIRST_TRUST

FIRST_TRUST_NAME

Name of provider e.g. hospital/clinic/NHS trust etc

PROVIDER_NAME

Date when the data made available i.e. date of loading

avail_from_dt

Basis of diagnosis. Broken up broadly into Clinical or Microscopic bases. Specific bases are: 0 = Death certificate only; 1 = Clinical; 2 = Clinical investigations; 3 = Specific tumour markers; [there is NO 4]; 5 = Cytology; 6 = Histology of metastasis; 7 = Histology of primary; [there is NO 8]; 9 = Unknown

basis_of_diagnosis

create_date

diagnosis_date

Refers to naming of staging classification system, and the tumour types. Colorectal malignancies

dukes

Refers to naming of staging classification system, and the tumour types. Female gynaecological cancers - ovary, vagina, endometrial, cervix

figo

Refers to the grade of neoplasm. In this case can be anaplastic, different levels of differentiation, T-cell, B-cell, and etc.

grade

Refers to which side of an organ, OR which side of a pair of organs the neoplasm is related to.  L = left; R = right; B = bilateral/both; M = midline; X = not known. Recording of laterality is generally limited to these main cancer types: tonsil, ear, sinus, lung, breast,ovary, fallopian tube, testis, kidney, eye, bone, melanoma, brain.

laterality

morphology

Encrypted patient reference number for data linkage.

patientid_e

This field is set if diagnosis came via screening. Y = diagnosed from a screening program; N = not diagnosed from a screen program; X = not known whether diagnosed from a screening program

screen_diagnosis

Encrypted WCISU patient reference number for data linkage.

system_id_e

All coded registrations for "behaviour of growth" are converted from the coding system used at the time of cancer registration to ICD-10 where possible when the WCISU reporting tables are built to create a consistent coded field in ICD Version 3, over time.  There will be NULL values where mappings have not been possible  and these additional coding fields supplied may need to be used.

Behaviour codes:
0 - Benign
1 - Uncertain whether benign or malignant /Borderline malignancy/Low malignant potential/Uncertain malignant potential
2 - Carcinoma in situ/Intraepithelial/Non-infiltrating/Non-invasive
3 - Malignant, Primary site
5 - Micro invasive
6 - Malignant, metastatic site/Malignant, secondary site
9 - Malignant, uncertain whether primary or metastatic site 
X = Unknown/not applicable

BEHAVIOUR_ICD10_O2

A unique code to identify the coding system used for registering the tumour (2,3,4,5,8,10,11,15,16,17,19,22). Coding systems for tumours have changed and been updated over time, with the systems mostly comprised of ICD and SNOMED revisions

CODING_SYSTEM

Coding systems for tumours have changed and been updated over time. 
The coding system field identifies the system that the SITE_CODED field were originally registered in.The systems are mostly comprised of ICD and SNOMED revisions: 

2 - ICD-9
3 - ICD-10/O2
4 - ICD-10/O3
5 - ICD -O-3
8 - ICD-O-2
10 - ICD-O-3 (2011)
11 - ICD-10rev4/O-2
15 - SNOMED/O-1
16 - SNOMED/O-2
17 - SNOMED/O-3
19 - ICD-O-3 (2016)
22 - ICD-O-3 (2019)

CODING_SYSTEM_DESC

Grading system specific to prostate cancer (C61)
Combined Gleason primary and secondary scores (+/- tertiary). The worst score is recorded, if both scores are the same but have different primary and secondary grades, the score with the highest primary grade is recorded first, i.e. 4+3=7 would be recorded over 3+4=7.

2, 3, 4, 5, 6, 7, 8, 9, 10, blank.

Typical Gleason Scores range from 6-10.
The higher the Gleason Score, the more likely that the cancer will grow and spread quickly.

-  Scores of 6 or less describe cancer cells that look similar to normal cells and suggest that the cancer is likely to grow slowly.

-  A score of 7 suggests and intermediate risk for aggressive cancer.  Scoring a 7 means that the primary score (largest section of the tumor) scored a 3 or 4.  Tumours with a primary score of 3 and a secondary score of 4 have a fairly good outlook, whereas cancers with a primary Gleason Score of 4 and a secondary score of 3, are more likely to grow and spread.

-  Scores of 8 or higher describe cancers that are likely to spread more rapidly, these cancers are often referred to as poorly differentiated or high grade.

GLEASON_COMBINED

ICDO morphology code and behaviour code of the tumour as originally registered, combined as a 5 digit histology code - the fifth digit designates the behaviour of the tumour

HISTOLOGY_CODED

PROVIDERCODE

Whether or not the tumour was detected by a national screening programme:  Wales screening programme includes Breast cancer (C50) introduced 2008 diagnosis onwards; Bowel (C18, C19, C20) from 2010 diagnosis onwards, and cervical (C53) 

Y = Yes
N = No
9 = Unknown

SCREENDETECTED

The code of the tumour as originally registered. Coding systems for tumours have changed and been updated over time.

SITE_CODED

Code range in extract C00 - C96, D00 - D48
All coded registrations for "site of tumour" are converted from the coding system used at the time of cancer registration to ICD-10 where possible when the WCISU reporting tables are built to create a consistent coded field in ICD Version 3, over time.  This is a 4-digit code.  There will be NULL values where mappings have not been possible and the additional coding fields supplied may need to be used for further details.

SITE_ICD10_O2

Cancer registry derived stage at diagnosis based on clinical and pathological information - 
"the registry stage is the stage at diagnosis, to the best knowledge of the registration officer staging the case, based on the TNM staging rules and all data submitted from Healthoards/Trusts on the case" 
The field has stages 0A,0I, 1, 2, 3, 4 with components such as 1A, 1B, etc, to two characters. When no information is available the following entries are used, the codes differ pre and post 2011:
X – Pre 2011: Tumours that either did not have a staging system or were not on the Cancer registries core list.
6 – Pre 2011: Tumours that would usually be staged but are unable to in this scenario due to either a lack of staging information or they were located in a core site with a morphology that did not map for staging e.g. Breast sarcoma
U – Post 2011: Tumours that cannot be staged because there is no staging system – includes most behaviour 0 and 1 tumours
? – Post 2011: Potentially stageable tumours where there was not enough information provided to stage

STAGE_BEST

Number that uniquely identifies a tumour.  A unique ID that is linked to a tumour. As someone can have more than one tumour, a patient can have multiple unique tumour ID

TUMOURID_E

Contains details of all invitations and treatment for a cervical cytology test and the type of recall the woman was on at time of invitation, as well as the surgery performed [if any]. Data available from approximately 1980 [will differ for various tables].

treatment

eventid_e

OPCS procedure code for the type of treatment

surgery_code

Operations, procedures and interventions as coded in OPCS-4, or more formally OPCS Classification of Interventions and Procedures version 4

OPCS4_CODE

Code of the organisation where the treatment event took place. This is the organisation acting as a healthcare provider

Encrypted Anonymised Linking Field (ALF). This field is derived from by double encryption after splitting demographic information and clinical information; the first encryption occurs in NHS Wales Informatics Service (NWIS), and the second in SAIL. If the NHS number is not supplied in the data extract, then matching methods are applied; please refer to ALF_MTCH_PCT.

alf_e

Generally anonymised information for individual patient, including gender, date of death [if any, due to neoplasm], which GP identified the neoplasm originally, and includes geographic information down to LSOA level. Data available from approximately 1980 [will differ for various tables].

wcisu_alf

Anonymised Linked Field Match Percentage.  This number is a match % score from probabalistic matching, when joining together anonymised data. This linkage process consists of matching against the Welsh Demographic Service by NHS number, where a valid number exists, and where there is no valid number then matching is attempted using first name, surname, date of birth, and postcode. This is an artificial score with no real-world meaning; i.e. a match of .99 does not mean there is a 99% chance the match is correct.  This number is assigned when deriving the Encrypted Anonymised Linking Field.

alf_mtch_pct

Anonymised Linked Field Status Code.  This is assigned when deriving the Encrypted Anonymised Linking Field.

alf_sts_cd

The date of the current extract data held within SAIL.

extract_dt

field_1

GP Practice Code as at Neoplasm identification

field_2

field_3

field_4

This is the sex (gender) of person, employee or patient. Can potentially assist in correct identification of gender-specific primary cancer sites. Can potentially be different from gender identity as stated/assigned at birth.

gndr_cd

The code for the 2001 Local Super Output Area [LSOA] of residence - NOT THE 2011 LSOA Code; this is a code created and maintained by Office for National Statistics.  Not to be confused with LSOA name or other LSOA fields.  1909 LSOAs exist in Wales (2011 data); these have a minimum population of 1000, and a max population of 3000.  The minimum number of households is 400, and the maximum number of households is 1200.  If these thresholds are breached, then LSOAs are either split or merged; however this is uncommon.

lsoa2001_cd

Date data was processed at HSW [Health Solutions Wales]

processed_date

Week of birth for the person/individual in question. The date of birth is tranlated to the date of the Monday that occurs prior to the actual date of birth - this is/was chosen by HIRU [Health Information Research Unit]. All age calculations will be accurate to +/- 7 days. Possible that this calculation could result in strange findings, such as finding individuals that have been prescribed medication prior to being born, or etc.

Welsh Cancer Intelligence and Surveillance Unit (WCSU)

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