The recent article by Laroche et al 1 is an eloquent reminder that standardised care, hopefully based upon evidence (or at least consensus), can help to ensure that the quality of care is based less on postcode and more upon clinical need. However, the authors and the accompanying editorial2 do not emphasise the problems in comparing surgical resection rates for lung cancer with other European countries and the USA.

Much international literature in this area is not directly comparable with that in the UK for at least one reason—namely, that the denominators used may be very different. One study quoted by Larocheet al from the Netherlands described a resection rate for lung cancer of over 20%,3 but used a denominator made up only of patients with a histological diagnosis seen at the related hospitals. The UK data commonly available comprise cases with and without …