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Peer-reviewedCC BY-NC 4.0BMJ Open

Exploring patterns of acute and primary care utilisation before diagnosis, during treatment and for 3 years postcompletion of surgery and adjuvant treatment in women with endometrial cancer: a protocol for a Victorian data linkage study

  • Nicole Kinnane1,2
  • Allison Drosdowsky1,3
  • Emma R Allanson4
  • Shaoke Lei3
  • Jennifer Chard5
  • Linda Mileshkin6,7
  • Jon Emery8
  • Nita Eng9
  • Nada Manoski9
  • Meinir Krishnasamy2,10
10 affiliations
  1. 1Centre for Health Services Research in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  2. 2Department of Nursing | School of Health Sciences, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
  3. 3Department of General Practice and Primary Care & Collaborative Centre for Genomic Cancer Medicine, The University of Melbourne, Melbourne, Victoria, Australia
  4. 4Division of Obstetrics and Gynaecology, The University of Western Australia—Perth Campus, Perth, Western Australia, Australia
  5. 5Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  6. 6Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  7. 7The University of Melbourne, The Sir Peter MacCallum Department of Oncology, Melbourne, Victoria, Australia
  8. 8Nanyang Technological University, Singapore
  9. 9Consumer and Community Engagement, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  10. 10Centre for Health Services Research in Cancer and VCCC Alliance, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Abstract

Introduction: Women with endometrial cancer have two to three times higher rate of pre-existing chronic cardiovascular risk factors including hypertension (59% vs 31%), obesity (34% vs 15%) and diabetes (26% vs 10%) compared with women without cancer. With a 5-year cancer-specific survival of 85%, these women are three times more likely to die of cardiovascular disease than they are to have a cancer recurrence. Surveillance for recurrence dominates post-treatment follow-up, a model misaligned with greatest health risks. Current approaches to endometrial cancer care may disrupt established management pathways for high-mortality risk chronic conditions and how best to manage chronic disease postcancer remains unclear. Women’s engagement with health services to manage chronic conditions before, during and after cancer treatment and what it means for long-term health is unknown. Linked data enables examination of healthcare utilisation across the care continuum.

Methods and analysis: This retrospective cohort study uses data accessed via the Victorian Comprehensive Cancer Centre (VCCC) Alliance Data Connect platform, an Australian platform that links Victorian general practice data: Primary Care Data Research Repository (PATRON); hospital data—Victorian Admitted Episodes Dataset (VAED), Victorian Radiotherapy Minimum Dataset (VRMDS), Victorian Emergency Minimum Dataset (VEMD), Victorian Integrated Non-Admitted Health Dataset (VINAH); and clinical registry data—Victorian Cancer Registry (VCR) and Victorian Death Index (VDI), managed in the secure environment of the Centre for Victorian Data Linkage (CVDL). Data span 2008–2022. Healthcare utilisation across acute and primary care settings will be mapped across three phases: prediagnosis, during treatment and 3 years post-treatment. Data will be analysed using descriptive statistics reporting frequency and percentage of encounters, mean and SD. Primary outcome is frequency and patterns of healthcare utilisation before, during and after endometrial cancer diagnosis and treatment. This includes frequency and type of cancer and non-cancer healthcare encounters, patterns of specialist versus general practice (GP) care, evidence of care associated with, or sought for, chronic diseases.

Ethics and dissemination: Study approved by the Office of Research Ethics and Integrity (Number 2025–23718-73133-20); Patron Data Governance (ID PAT 0001138), The University of Melbourne, Victoria, Australia. Results will be disseminated via funder reports, peer-reviewed publication, professional and consumer conferences.

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    Chunyan Tan, Huibo Dai, Xingya Liu +3
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  3. Secondary mental healthcare utilisation and costs before and after diagnosis of mild cognitive impairment or dementia: a retrospective observational cohort study from a South London mental health service.
    Gillian Eaglestone, Charlotte Stoner, Rosana Pacella +1
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  4. Interobserver agreement in the diagnosis of endometrial atypical hyperplasia and the contribution of PTEN immunohistochemistry
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  5. Cytomorphological criteria for the differential diagnosis of endometrial hyperplasia and endometrial cancer
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Cite

BibTeXRIS
BibTeX
@article{kinnane2026exploring,
  title = {{Exploring patterns of acute and primary care utilisation before diagnosis, during treatment and for 3 years postcompletion of surgery and adjuvant treatment in women with endometrial cancer: a protocol for a Victorian data linkage study}},
  author = {Nicole Kinnane and Allison Drosdowsky and Emma R Allanson and Shaoke Lei and Jennifer Chard and Linda Mileshkin and Jon Emery and Nita Eng and Nada Manoski and Meinir Krishnasamy},
  journal = {BMJ Open},
  year = {2026},
  month = oct,
  doi = {10.1136/bmjopen-2026-126305},
  url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-126305},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Exploring patterns of acute and primary care utilisation before diagnosis, during treatment and for 3 years postcompletion of surgery and adjuvant treatment in women with endometrial cancer: a protocol for a Victorian data linkage study
AU  - Nicole Kinnane
AU  - Allison Drosdowsky
AU  - Emma R Allanson
AU  - Shaoke Lei
AU  - Jennifer Chard
AU  - Linda Mileshkin
AU  - Jon Emery
AU  - Nita Eng
AU  - Nada Manoski
AU  - Meinir Krishnasamy
PY  - 2026
DA  - 2026/10/27
JO  - BMJ Open
DO  - 10.1136/bmjopen-2026-126305
UR  - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-126305
AB  - Introduction: Women with endometrial cancer have two to three times higher rate of pre-existing chronic cardiovascular risk factors including hypertension (59% vs 31%), obesity (34% vs 15%) and diabetes (26% vs 10%) compared with women without cancer. With a 5-year cancer-specific survival of 85%, these women are three times more likely to die of cardiovascular disease than they are to have a cancer recurrence. Surveillance for recurrence dominates post-treatment follow-up, a model misaligned with greatest health risks. Current approaches to endometrial cancer care may disrupt established management pathways for high-mortality risk chronic conditions and how best to manage chronic disease postcancer remains unclear. Women’s engagement with health services to manage chronic conditions before, during and after cancer treatment and what it means for long-term health is unknown. Linked data enables examination of healthcare utilisation across the care continuum.  Methods and analysis: This retrospective cohort study uses data accessed via the Victorian Comprehensive Cancer Centre (VCCC) Alliance Data Connect platform, an Australian platform that links Victorian general practice data: Primary Care Data Research Repository (PATRON); hospital data—Victorian Admitted Episodes Dataset (VAED), Victorian Radiotherapy Minimum Dataset (VRMDS), Victorian Emergency Minimum Dataset (VEMD), Victorian Integrated Non-Admitted Health Dataset (VINAH); and clinical registry data—Victorian Cancer Registry (VCR) and Victorian Death Index (VDI), managed in the secure environment of the Centre for Victorian Data Linkage (CVDL). Data span 2008–2022. Healthcare utilisation across acute and primary care settings will be mapped across three phases: prediagnosis, during treatment and 3 years post-treatment. Data will be analysed using descriptive statistics reporting frequency and percentage of encounters, mean and SD. Primary outcome is frequency and patterns of healthcare utilisation before, during and after endometrial cancer diagnosis and treatment. This includes frequency and type of cancer and non-cancer healthcare encounters, patterns of specialist versus general practice (GP) care, evidence of care associated with, or sought for, chronic diseases.  Ethics and dissemination: Study approved by the Office of Research Ethics and Integrity (Number 2025–23718-73133-20); Patron Data Governance (ID PAT 0001138), The University of Melbourne, Victoria, Australia. Results will be disseminated via funder reports, peer-reviewed publication, professional and consumer conferences.
SN  - 2044-6055
SN  - 2044-6055
ER  -