Regional Variation in Lung Cancer Stage at an Irish Rapid Access Lung Clinic

Abstract

Introduction: Regional variation in cancer outcomes is undesirable. We aim to evaluate regional variation in lung cancer in Ireland focusing on stage at presentation. Methods: A retrospective study was performed on patients who underwent surgical resection of primary lung cancer from June 2013 to March 2020. Patients included attended the St. Vincent’s University Hospital rapid access lung clinic (RALC). Patients were divided into two groups depending on regional variability with Dublin and Wicklow assigned as Group 1 and the remainder assigned to Group 2. Pathological tumour size and lymph node status were compared between the two groups. Results: Complete data was available on 152 patients. Group 1 (n=97) had significantly lower median tumour size (24.74 mm) compared to Group 2 (31.72 mm) (P = 0.026). Patients in group 1 had significantly lower stage (stage II 13.4%, stage III 9.3%) compared to Group 2 (stage II 29%, stage III 16.3%) (P = 0.013). Group 1 showed a lower incidence of squamous cell carcinoma (21.6%) compared to Group 2 (30.9%). Conclusion: Regional variation in cancer presentation is evident in this study. Larger tumors and more advance stage are associated with a more rural location. This is seen in a clinic service with equal access of both populations to diagnostic modalities and treatment, suggesting differences at presentation rather than evaluation.