Recent trends in resection rates among non-small cell lung cancer patients in England 


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Sharma P. Riaz1, Karen M. Linklater1, Richard Page2, Michael D. Peake3,4, Henrik Møller1, Margreet Lüchtenborg1
1King’s College London, Thames Cancer Registry, London, UK, 2Department of Thoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK, 3National Cancer Intelligence Network, London, UK, 4Department of Respiratory Medicine, Glenfield Hospital, Leicester, UK

Background

Lung cancer resection rates are low in England, compared with some other countries. We analysed the trends in surgical resection by age, sex, socioeconomic deprivation and type of surgical procedure in England in recent years.

Method

Data on 286,217 non-small cell lung cancer patients diagnosed between 1998 and 2008 were extracted from the English Cancer Repository Dataset and information on surgical resection for these patients was retrieved from linked records hospital episodes statistics records. We calculated the odds ratio of undergoing surgery per one year increment by age, sex, socioeconomic deprivation and surgical procedure.

Results

The proportion of patients undergoing surgery increased from 8.8% in 1998 to 10.6% in 2008. The increase was similar between levels of socioeconomic deprivation (most affluent: OR=1.017 per one year calendar increment, 95% CI [1.006-1.028] and most deprived: OR=1.015, 95% CI [1.007-1.023]), slightly more pronounced among females (OR=1.023, 95% CI [1.016-1.029]) than males (OR=1.010, 95% CI [1.005-1.015]) and most prominent with increasing age (70-74 age group: OR=1.033, 95% CI [1.024-1.042], 75-79 age group: OR=1.051 95% CI [1.041-1.062], 80-84 age group: OR=1.102, 95% CI [1.080-1.124], and 85+ age group: OR=1.130, 95% CI [1.069-1.193]) .The proportion of patients receiving pneumonectomy decreased from 24.4% in 1998 to 10.1% in 2008. In contrast, the proportion of patients receiving lobectomy increased from 56.5% to 69.5% in 2002 and remained relatively stable thereafter. There was also an increase between 1998 to 2008 in sleeve and wedge resection from 0.4% to 1.5% and 15.8% to 16.3%, respectively.

Conclusion

Resection rates have increased in England in recent years and seem to have been most marked in older age groups.