Introduction Several recent studies have reported the overall survival of patients with lung cancer in England is improving. However, when compared with other European and North American countries, England still has worse survival figures. The aim of this study is to look at the spectrum of people with lung cancer and to identify groups in which the survival is improving.
Methods We used data from the National Lung Cancer Audit to identify patients with a proven or presumed diagnosis of non-small cell lung cancer in England. We stratified patients according to their performance status (PS) and clinical stage of cancer. We then divided patients into ‘year groups’ based on their year of diagnosis. People diagnosed in 2004 and 2005 were grouped together and used as our comparator group. We performed Cox regression analyses to calculate the changes in overall survival for patients diagnosed each year between 2004/05 to 2010.
Results Our cohort consisted of 66,433 patients diagnosed between January 2004 and December 2010. Based on the stratification by stage and PS, we observed that having adjusted for confounders including sex, age, ethnicity, comorbidity and source of referral, the overall survival for patients in group 1 (patients with good PS and stage IA-IIB) has improved every year (adjusted HR 0.74 in 2010, 95% CI 0.68 – 0.82), while the survival for patients in groups 4 and 5 (i.e. patients with poor PS and stage) has remained essentially stable (see figure 1).
Conclusion Our results demonstrate that survival has improved for limited groups of patients with lung cancer over the last 6 years. Stratification by clinical stage and PS has shown that survival is improving for patients with early stage cancer and good PS. Further research is required to investigate why this improvement has occurred, and to ensure all patients have equal access to advances in lung cancer care. Increasing the proportion of patients in this subgroup, with good PS and early stage disease, will also improve our survival figures.
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