RT Journal Article SR Electronic T1 Inequalities in outcomes for non-small cell lung cancer: the influence of clinical characteristics and features of the local lung cancer service JF Thorax JO Thorax FD BMJ Publishing Group Ltd and British Thoracic Society SP 1078 OP 1084 DO 10.1136/thx.2011.158972 VO 66 IS 12 A1 Anna L Rich A1 Laila J Tata A1 Catherine M Free A1 Rosamund A Stanley A1 Michael D Peake A1 David R Baldwin A1 Richard B Hubbard YR 2011 UL http://thorax.bmj.com/content/66/12/1078.abstract AB Background The treatment given to patients with lung cancer and survival vary between and within countries. The National Lung Cancer Audit (NLCA) linked to Hospital Episode Statistics was used to quantify the extent to which these outcomes are influenced by patient features and/or hospital facilities and performance indicators.Methods All patients with a histological diagnosis of non-small cell lung cancer (NSCLC) were included. Logistic regression was used to quantify the independent influence of features of both patients and hospitals on the likelihood of having surgery and Cox regression was used for survival analyses.Results There were 34 513 patients with NSCLC in our dataset. After adjusting for age, sex, performance status, stage and Charlson Index of comorbidity, patients with NSCLC first seen in thoracic surgical centres (27% of the cohort) were 51% more likely to have surgery than those seen in non-surgical centres (adjusted OR 1.51, 95% CI 1.16 to 1.97). Resection rates varied from 13% to 17% between non-surgical and thoracic surgical centres. Surgery was the most powerful determinant of overall survival (adjusted HR 0.41, 95% CI 0.39 to 0.44).Conclusion A minority of patients with NSCLC first seen in a thoracic surgical centre are more likely to have surgery and to benefit from the survival advantage this confers. This finding suggests that there is an opportunity to improve the outcome for patients with lung cancer in England by optimising access to thoracic surgeons in non-surgical centres.