P3.03-038 Improving Quality of Care and Outcomes for Patients Diagnosed with Pleural Mesothelioma in England: Topic: Mesothelioma Clinical

Abstract

Mesothelioma data has been collected by the National Lung Cancer Audit (NLCA) since it was introduced in 2004 to improve standards of care for patients in the UK and ultimately improve outcomes. The first mesothelioma-specific report combining data submitted to the audit from 2008-2012 was reported in 2014, capturing approximately 85 per cent of total incident mesothelioma cases. This same year, the NLCA switched from using a bespoke dataset to use the generic Cancer Outcomes and Services Dataset (COSD), linked to other National Cancer Registration and Analysis Service (NCRAS) registry datasets, as its primary data source. This dataset change has allowed data for all mesothelioma cases diagnosed during 2014, in England, to be analyzed for the first time and reported here. Using 2014 COSD data submitted to the NLCA for all hospital trusts in England, we have analyzed demographic, diagnostic and active treatment data items and in particular, have calculated the proportion of cases receiving histological subtype confirmation, palliative chemotherapy and per cent surviving to one year after diagnosis, both nationally and by strategic cancer network (SCN). There were 2179 cases of pleural mesothelioma diagnosed in England in 2014. Histological confirmation of diagnosis was very high, but the proportion of mesothelioma cases without histological sub-classification (M9050/3) was 47%. This unspecified mesothelioma rate varied from 32.6 up to 74.4% by cancer network across England. Overall, palliative chemotherapy was given to 51% of patients with performance status (PS) 0-1, however at network level, this varied from 42.2% up to 77.4%. For all cases of mesothelioma, the 1 year overall survival was 43% with variation by network from 37.5 to 55.6% with adjusted odds ratios (OR) ranging from OR 0.8 up to 1.56. There has been improvement in the proportion of mesothelioma patients in England receiving histological subtyping compared to previous years and in the proportion of patients with good PS being treated with palliative chemotherapy. However, there is still marked variation across the country and addressing this may improve national outcomes further. Cancer networks and individual hospitals should examine their results and implement mechanisms to ensure best practice is being followed.