Introduction The National Lung Cancer Audit, now in its 8th year, is run jointly by the Royal College of Physicians and The Information Centre for health and social care, and is commissioned by the Healthcare Quality Improvement Partnership (HQIP). Over this period, the audit has collected rich data of increasing quality and has charted improving standards of care for patients, as well as persistent variation across organisations which in most cases is independent of case-mix.
Methods Although several other countries also submit data to the audit, this abstract presents provisional results for England only for patients first seen in 2012.
Results 31,003 patient records were submitted with the improvement in recording of stage being the most noteworthy change in data quality. Full details are given in Table 1. Spirometry data is available for 63% of Stage I-II/PS 0–1 NSCLC patients. The histological confirmation rate has risen slightly after a dip in the previous year, and the proportion of patients with non-subtyped NSCLC continues to fall. There have been small but incremental rises in the anti-cancer treatment rate, the resection rate in histologically-confirmed NSCLC, and the proportions of patients having the input of specialist nurses and having the nurse present at the time of diagnosis. Increases are also noted in the proportion having CT scan before bronchoscopy (90%) and having chemotherapy for locally advanced NSCLC with good PS (57%).
Variation in practice still exists–for example, the resection rate in Stage I-II NSCLC varies from 35% to 62% across the cancer networks.
Our final presentation will contain further analyses of survival across the audit lifespan.
Conclusions The lung cancer community should be very proud of the quality of data that they provide to the audit, data which provides clear evidence of gradually improving standards of care. Demonstrating that these improved diagnostic pathways and increased treatment rates translate into longer survival has so far proven elusive since short-term survival is heavily influenced by the large numbers of patients presenting with advanced incurable disease, but as the data matures it is hoped that longer-term survival will indeed increase.
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