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30-day mortality post-Systemic Anti-Cancer Therapy - Case-Mix Adjusted Rates

Explore the new 30-day mortality post-Systemic Anti-Cancer Therapy (SACT) case-mix adjusted rates (CMAR) report. This work is produced by the National Disease Registration Service (NDRS) team, as part of the SACT data programme.

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The new 30-day mortality post-SACT CMAR report includes patients diagnosed with cancer in England and treated with SACT, with each report focusing on a defined cancer type and treatment period.

This report considers patients diagnosed with breast cancer who received treatment in 2021.

The report shows rates of deaths within 30 days of SACT treatment, both unadjusted (observed) and adjusted for key patient factors. Overall 30-day mortality rates are presented for each NHS Trust identified as treating breast cancer patients with SACT in 2021. Overall rates are supplemented with rates broken down by age group, deprivation quintile, ethnicity group, and intent of treatment.

The analysis presented in this report uses routine data reported by NHS Trusts in England through their monthly routine SACT data uploads.


The SACT data has been provided by patients and collected by the NHS as part of their care and support. The data is collated, maintained and quality assured by the National Disease Registration Service, which is part of NHS England.


Each Trust will treat a wide variety of patients depending on the population they serve and the services they provide. Thus, case-mix adjusted 30-day mortality rates have been produced which take into account (where these variables are appropriate or available) differences in the age, deprivation quintile, ethnicity, performance status, and co-morbidity score of patients within each Trust. As a result, the case-mix adjusted rates are based on an average group of patients as opposed to the Trust’s own group of patients.

Case-mix adjusted 30-day mortality rates can be compared between Trusts and within Trusts over time. This aims to support clinical governance and help NHS Trusts identify areas where clinical governance could be improved.

Systemic Anti-Cancer Therapy (SACT) data set

The SACT dataset is a population-based resource of SACT activity reported routinely by NHS Trusts in England. Data are collected on the SACT treatments of adult and paediatric patients, delivered in secondary and tertiary settings with the intention of improving survival, delaying further cancer progression or development, and improving disease-free or progression-free survival.

For more information on the SACT dataset, please see the Data Resource Profile on the Oxford Academic website.

All NHS Trusts identified as treating breast cancer patients with SACT in England in 2021 are included in this report.

Some NHS Trusts have been excluded due to data quality issues, such as less than 70% completeness for patient Performance Status.

Find out more about the SACT data set.

Methodological review

The 30-day mortality post-SACT CMAR work was first released in June 2020 on a quarterly release schedule. In February 2022, the SACT analysis team decided to pause the planned 30-day mortality post-SACT CMAR release schedule in order to perform an evaluation of the work to date and to seek and address user feedback. Thus, with this new report come several changes covering the methodology used, the metrics included, and the presentation method. For full details on the changes made, and for support in using and interpreting the report, please see the report documentation available to download via the dashboard.

All releases prior to this report, which use the historic methodology, can be reviewed on the CancerData website.

Release schedule

The release schedule for the new 30-day mortality post-SACT CMAR report is currently being agreed. This will be detailed here once finalised within NDRS.

Feedback and support

The NDRS SACT team welcomes your feedback on the new report and is happy to help with any queries you may have. If you would like to provide feedback, or if you would like support or further information about this work, then please do not hesitate to contact us via the SACT helpdesk at [email protected]


Select the box below to download detailed guidance for using and interpreting the 30-day mortality post-SACT CMAR report. The guidance below relates to the recent report focusing on patients diagnosed with breast cancer who received SACT in 2021:

Last edited: 6 July 2023 2:20 pm