The National Lung Cancer Audit in the United Kingdom: Results after 4 years.

Abstract

6123 Background: The National Lung Cancer Audit is run jointly by the Royal College of Physicians and The Information Centre for health and social care. Its development was driven by the realization that lung cancer outcomes vary widely across Great Britain and are poor compared to other western countries. The aim is to record outcomes in lung cancer on a large scale and through case-mix adjustment, start to explain the wide variations noted and facilitate service improvement. Methods: All hospitals are invited to participate in this audit, which is not mandatory. The dataset includes over 100 fields covering demographics, referral, investigations, diagnosis, treatment and survival and includes age, sex, postcode, stage, and performance status allowing case-mix adjustment to be carried out. Incident cases of lung cancer and mesothelioma are uploaded to a central database and cases are analysed on a “date first seen” basis. Although Scotland submits a subset of data, this abstract presents results for England and Wales only. Results: There has been a yearly increase in participation and by June 2008, all networks in Great Britain were contributing to the audit. In 2008, there were 28,389 records submitted from England and Wales, representing 85% of the annual incidence and 94% of those presenting to secondary care. The table below shows the quality of the data submitted as well as process and outcome measures. Conclusions: These results highlight the considerable achievement of the National Lung Cancer Audit in collecting data and suggest that care for lung cancer patients is slowly improving. However, wide variations in outcomes persist between organisations. The quality of the data now allows further analysis to determine whether such variations can be explained by case-mix. Such information will be a powerful lever for reducing variation and further improving quality of care and outcomes. Data completeness 2005 (%) 2006 (%) 2007 (%) 2008 (%) Histology 79 78 82 90 PS 66 77 80 87 Staging 51 55 70 77 Process and outcomes 2005 (%) 2006 (%) 2007 (%) 2008 (%) Confirmed histological diagnosis 68 66 65 67 Discussed at MDT? 79 84 87 89 Any anticancer treatment? 45 50 52 54 Overall surgical resection rate 9 9.4 10.3 11.2 NSCLC resection rate 13.8 14.3 15.2 16 SCLC chemotherapy rate 58 62 65 63 No significant financial relationships to disclose.