Appendix 4 - Glossary

Age standardised rate, Directly standardised rate

Age standardised rates are used to compare rates for different populations accounting for differences in age distribution. They identify differences between populations which are not due to differences of their age distributions.

Directly standardised rates are a specific way to calculate age standardised rates using a ‘standard’ population (European Standard Population 2013) as a reference. Directly standardised rates adjust for age by assuming that the age distribution of the population being studied is the same as that of the standard population. This enables direct comparisons between populations with different age profiles.

Borderline/non-Borderline

Borderline ovarian tumours are abnormal cells that form in the tissue covering the ovary. They are different to ovarian cancer because they do not grow into the supportive tissue of the ovary (the stroma). They tend to grow slowly and in a more controlled way than cancer cells.
The main treatment for borderline tumours is surgery. Most women are cured and have no further problems. There is a small risk of the tumour coming back. Very rarely, the borderline tumour cells change into cancer cells.

Cancer Alliances

CA

The 19 Cancer Alliances in England bring together the key organisations in their regions to coordinate cancer care and to plan for and lead delivery of improved outcomes for patients locally.

Cancer Analysis System

CAS, AV

The Cancer Analysis System is the database system maintained and used by the National Cancer Registration and Analysis Service, containing data on all tumours registered in England. Versions of the CAS are indicated by “AV” with a numerical indication of the date of the data. Data in this report are derived from the CAS. Further documentation can be found in the Data Resource Profile cited below.

Cancer registry

NCRAS

The National Cancer Registration and Analysis Service (NCRAS) collects data on all cases of cancer that occur in people diagnosed in England. The data is used to support public health, healthcare and research.

Carcinoma

Category of types of cancer that develop from epithelial cells.

Clinical Commissioning Groups

CCGs

Clinical Commissioning Groups (CCGs) commission most of the hospital and community NHS services in the local areas for which they are responsible. Commissioning involves deciding what services are needed for diverse local populations and ensuring that they are provided. All GP practices now belong to a CCG, but CCGs also include other health professionals, such as nurses.

Comorbidity

A disease or condition that someone has in addition to the health problem being studied or treated (i.e. cancer).

Complete approach

Method of survival analysis that includes all patients diagnosed until the end of a maximum follow up time.

Count

Number of patients or of tumours with relevant characteristics.

Crude rate

Rate derived directly from the counts of relevant patients/tumours and the size of the population. For example, the crude incidence rate of ovarian, fallopian tube and primary peritoneal carcinomas in 2017 is the number of such tumours diagnosed divided by the number of women alive in England in that year.

Because cancer is not common, this is often multiplied up and expressed as a count per 100,000 person-years.

Emergency Presentation

An emergency presentation is a diagnosis of cancer that arose from an unscheduled (or emergency or unplanned) hospital admission. This is to be contrasted with other Routes to Diagnosis, for example, diagnosis via referral from a GP.

Fallopian tube

Fallopian tubes carry eggs from the ovaries to the uterus. Serous carcinomas of the fallopian tube are considered to be the same disease entity as serous cancers of the ovary and primary peritoneal carcinoma, which is why cancers at all 3 sites are collected in this report.

FIGO stage

FIGO

System for staging of gynaecological cancers, published by the International Federation of Gynaecology and Obstetrics (FIGO).

ICD codes

ICD

International Classification of Diseases is a medical classification and coding list for the identification of diseases, signs and symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as maintained by the World Health Organization (WHO).

ICD-10 classifies cancers by site and behaviour (malignancy) and ICD-O classifies cancers by site, morphology and behaviour.

Incidence

The number of new cases of cancer, usually expressed as a rate by dividing by the total population at risk during a certain period.

International Cancer Survival Standard weights

ICSS

Weights used for age standardisation of survival data for cancer. The weights reflect the age distribution for the cancer population considered, rather than the population at large.

Malignant

Malignant tumours are considered to be cancer. Malignant means characterised by the tendency to become progressively worse. Often characterised by anaplasia, invasiveness and /or metastases.

Morphology

Morphology is the type of a tumour, as diagnosed by a pathologist looking at the shape of the cells through a microscope. The morphological type of a tumour can be important in understanding how to treat that tumour and what expected outcomes might be.

Mortality

Cancer mortality is the number of deaths from cancer in a specific population within a specific period of time, usually a year. It usually only includes deaths where cancer is mentioned as an underlying cause of death on death certificates.

Cancer mortality is often expressed as a crude or age standardised rate. Cancer mortality rates are a standard measure of the frequency of deaths from cancer within a specific period of time relative to a fixed population size, usually 100,000 person-years.

Multidisciplinary team

MDT

MDTs bring together experts in specific areas of medicine and care, and usually meet every week to discuss the diagnosis, treatment and care of individual cancer patients.

NHS Long Term Plan

The NHS Long Term Plan was published in January 2019 and sets out major goals for the NHS over the following 10 years. This includes some cancer-specific targets, notably a goal to diagnose 75% of all cancers at early stage (stages 1 to 2) by 2028.

NHS trusts

NHS hospital trusts are organisational units within the National Health Service in England, providing secondary health services in a particular local area.

Performance status

Performance status is an attempt to quantify cancer patients' general well-being and activities of daily life. This is captured as a WHO (World Health Organization) score between 0 and 5.

Peritoneum

C48

The peritoneum is the serous membrane forming the lining of the abdominal cavity. Primary peritoneal carcinomas are considered to be the same disease entity as serous carcinomas of the ovarian or fallopian tube, which is why cancers at all 3 sites are collected in this report.

Person-years

The size of the population in each year, summed over years. Using person-years for populations when calculating incidence and mortality rates allow us to compare rates from different lengths of time.

Primary peritoneal carcinomas

Cancer of the epithelial cells in the peritoneum. Primary peritoneal carcinomas are considered to be the same disease entity as serous carcinomas of the ovarian or fallopian tube, which is why cancers at all 3 sites are collected in this report.

Stage

Stage describes the extent or severity of a person’s cancer. Diagnosis at earlier stage leads to improved prognosis, treatments and outcomes in comparison with cancers diagnosed at a later stage.

Standard population

ESP2013

Standard population is an example distribution of ages in the population and is used for direct age-standardisation. (See “Age standardised rate” above.) This report uses the European Standard Population 2013.

Survival

Crude survival rates are calculated as the number of patients who survive a certain length of time since their diagnosis, divided by the total number of patients in the group.
Net survival rates, published here, are survival rates adjusted so that they better estimate the proportion of patients dying of cancer rather than other causes.

Sustainability and Transformation Partnership

STP

The 44 STPs are areas (covering all of England), where local NHS organisations and councils have drawn up shared proposals in their locality to improve health and care in the areas they serve in partnership.

World Health Organization

WHO

The World Health Organization directs and coordinates international health within the United Nations system. The WHO classification systems for cancer sites (ICD-10, ICD-O) and performance status are used in the cancer registry.