Patterns of initial management of lung cancer in the Republic of Ireland: a population-based observational study

Abstract

Objectives: To examine geographic and temporal trends in the patterns of initial management of lung cancer in Ireland, and to describe differences in case management according to health board of residence. Design: Population-based observational study using the database of the National Cancer Registry of Ireland. Patients: 7286 patients with primary malignant lung tumours who were diagnosed in Ireland during the 5-year period from 1994 to 1998. Methods: We compared health boards in terms of treatment patterns of small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) cases adjusting for differences in age, gender, and deprivation status. Result: Only half of the patients received any cancer-specific treatment. Radiotherapy was the most commonly employed single-treatment modality (21.7%) followed by surgery (12.3%) and chemotherapy (8.8%). Relative to the Eastern Health Board, the risk of being untreated was significantly higher for NSCLC patients living in the Western, Mid-Western, North, and South-Eastern Health Boards. For SCLC, only the Mid-Western and South-Eastern Heath Boards had significantly higher relative risks. For both groups, older patients were less likely to receive treatment, but we could not adjust for stage and comorbidity. Conclusion: We found wide regional variations in treatment rates of lung cancer in Ireland.