Background The purpose of this study was to identify trends in survival and chemotherapy use, during the duration of the National Lung Cancer Audit (NLCA), for individuals with small-cell lung cancer (SCLC) in England.

Methods We used data from the NLCA database to identify people with histologically proven SCLC from 2004 to 2009. We used Hospital Episode Statistics (HES) database and NLCA to identify patients with codes of receiving chemotherapy, while NLCA was used to identify radiotherapy. We calculated the median survival by stage and observed the changing patient features of the cohort. We also looked at the proportions of patients with records of chemotherapy and/or radiotherapy over the years.

Results 11,603 patients were diagnosed with SCLC in our cohort. The median survival was 6 months; 1 year for limited stage and 4 months for extensive stage. 70% received chemotherapy and this proportion did not change overtime. Patient features including sex, age and performance status remained stable throughout the years (χ² p-value 0.25, 0.93 & 0.08 respectively). There has been an increase in the proportion of patients that had a record of receiving chemotherapy and radiotherapy each year in both limited and extensive stage disease (from 19% to 36% in limited & from 10% to 17% in extensive stage from 2004 to 2009) (table 1). Patients who had a record for chemotherapy and radiotherapy had better survival in days compared with those who received only chemotherapy or no treatment independent of stage (334 days for chemotherapy & radiotherapy vs. 240 days for chemotherapy alone, 82 days for radiotherapy alone & 25 days for no treatment).

Conclusion Since 2004, when the NLCA was established, the recorded use of chemotherapy and survival in days has remained static. We have found an increasing trend in patients receiving chemotherapy & radiotherapy which corresponds to better survival compared with other treatments. We were unable to see if these patients received these therapies for palliative or curative purpose; however the new chemotherapy and radiotherapy database soon to be linked with the NLCA would be better suitable to answer these questions.