Population-based data on lung cancer from the UK: The National Audit and beyond


Year:

Session type:

Michael Peake1
1Glenfield Hospital, Leicester, UK

Abstract

Five years ago we knew very little about the care and outcomes of lung cancer patients in the UK except for Cancer Registry-derived epidemiological data on incidence, mortality and 5 year survival rates. The National Lung Cancer Audit began in 2005 and since then, together with the emergence of the National Cancer Intelligence Network (NCIN) and the International Cancer Benchmarking Project (ICBP), there has been an explosion of new population-based intelligence. One important change has been the collection of data relating to case mix factors, e.g. stage, performance status and co-morbidity. We also know much more about details of the diagnostic process, treatment, referral routes and short term survival, all of which are fed back to hospital trusts and cancer networks. Huge variations by hospital trust and cancer network have emerged in all the variables that are now measured, particularly radical treatment rates and survival. We also know now that this variation cannot be fully explained by differences in case-mix. Over this period we have observed steadily increasing population coverage (now nearing 100%) and data completeness, together with improvements in most of the ‘headline indicators’. This combined with evidence that MDTs and networks are using the data regularly, suggests that the process is having a positive impact on standards of care. The linkage of data from various sources, a central aim of the NCIN, is also providing new insights, an example of which is the demonstration of a positive relationship between surgical resection rate by place of residence and survival. UK lung cancer survival consistently falls behind most other comparable countries; the ICBP has as its aim explaining the reasons underlying this.

It is not an understatement to say that we are witnessing a revolution in cancer intelligence in the UK and nowhere is this truer than for thoracic cancers.