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Lung cancer
Lung cancer in Teesside (UK) and Varese (Italy): a comparison of management and survival
  1. A Imperatori1,
  2. R N Harrison2,
  3. D N Leitch2,
  4. F Rovera1,
  5. G Lepore3,
  6. G Dionigi1,
  7. P Sutton2,
  8. L Dominioni1
  1. 1Center for Thoracic Surgery, University of Insubria, Varese, Italy
  2. 2Department of Respiratory Medicine, University Hospitals of North Tees and Hartlepool, North Tees and Hartlepool NHS Trust, Hardwick, Stockton on Tees TS19 8PE, UK
  3. 3Department of Respiratory Medicine, Ospedale S Antonio Abate, Gallarate, Italy
  1. Correspondence to:
    Dr A Imperatori
    Center for Thoracic Surgery, University of Insubria, Ospedale di Circolo, Viale Borri 57, 21100 Varese, Italy; andrea.imperatori{at}uninsubria.it

Abstract

Background: The survival of lung cancer patients in the UK is lower than in other similar European countries. The reasons for this are unclear.

Methods: Two areas were selected with a similar incidence of lung cancer: Teesside in Northern England and Varese in Northern Italy. Data were collected prospectively on all new cases of lung cancer diagnosed in the year 2000. Comparisons were made of basic demographic characteristics, management, and survival.

Results: There were 268 cases of lung cancer in Teesside and 243 in Varese. Patients in Teesside were older (p<0.05), were more likely to have smoked (p<0.001), had a higher occupational risk (p<0.001), higher co-morbidity (p<0.05), and poorer performance status (p<0.001). Fewer patients in Teesside presented as an incidental finding (p<0.001) and the histological confirmation rate was lower than in Varese (p<0.01). In Teesside there were more large cell carcinomas (p<0.001), more small cell carcinomas (p<0.05), and fewer early stage non-small cell lung cancers (p<0.05). The resection rate was lower in Teesside (7% v 24%; p<0.01) and more patients received no specific anti-cancer treatment (50% v 25%; p<0.001). Overall 3 year survival was lower in Teesside (7% v 14%; p<0.001). Surgical resection was the strongest multivariate survival predictor in Varese (HR = 0.46) and Teesside (HR = 0.31). Co-morbidity in Teesside resulted in a significantly lower resection rate (p<0.001).

Conclusions: Patients with lung cancer in Teesside presented at a later stage, with more aggressive types of tumour, and had higher co-morbidity than patients in Varese. As a result, the resection rate was significantly lower and survival was worse.

  • NSCLC, non-small cell lung cancer
  • SCLC, small cell lung cancer
  • lung cancer
  • management
  • surgical resection rate
  • survival

https://doi.org/10.1136/thx.2005.040477

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    Footnotes

    • Published Online First 11 November 2005

    • This study was supported by Provincia di Varese with a research scholarship to Dr A Imperatori and by research grants from COFIN 2002–2003 Ministero dell’Università e della Ricerca Scientifica, Italy and from Associazione PRE.DI.CA, Varese, Italy.

    • Competing interests: none declared.

    • The study sponsors had no involvement in the design of the study, the collection, analysis, and interpretation of data, in the writing of the report, or in the decision to submit the paper for publication. The authors are responsible for the research which they have designed and carried out, and for drafting and revising the submitted manuscript. All the authors have seen and approved the final version.

      AI planned the analysis, collected data, interpreted data, and helped to write the report. DNL, GL, FR, GD and PS collected and helped to analyse data. RNH and LD planned the analysis, interpreted data and wrote the report.