Inequalities in outcomes for non-small cell lung cancer: the influence of clinical characteristics and features of the local lung cancer service

Rich, Anna; Tata, Laila J.; Free, C.M.; Stanley, R; Peake, Michael; Baldwin, David R; Hubbard, Richard

doi:10.1136/thx.2011.158972

Cited by 71 publications

(78 citation statements)

References 21 publications

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“…For England and Wales, the National Lung Cancer Audit has shown significant regional inequalities in resection rates and other active treatment rates [55][56][57]. Several Norwegian studies have shown regional variations in resection rates and risk factors for post-operative mortality, as well as in the radiotherapy and chemotherapy regimens used [58][59][60][61].…”

Section: Resultsmentioning

confidence: 99%

The European initiative for quality management in lung cancer care

Blum¹,

Rich²,

Baldwin³

et al. 2014

European Respiratory Journal

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Lung cancer is the commonest cause of cancer-related death worldwide and poses a significant respiratory disease burden. Little is known about the provision of lung cancer care across Europe. The overall aim of the Task Force was to investigate current practice in lung cancer care across Europe.The Task Force undertook four projects: 1) a narrative literature search on quality management of lung cancer; 2) a survey of national and local infrastructure for lung cancer care in Europe; 3) a benchmarking project on the quality of (inter)national lung cancer guidelines in Europe; and 4) a feasibility study of prospective data collection in a pan-European setting.There is little peer-reviewed literature on quality management in lung cancer care. The survey revealed important differences in the infrastructure of lung cancer care in Europe. The European guidelines that were assessed displayed wide variation in content and scope, as well as methodological quality but at the same time there was relevant duplication. The feasibility study demonstrated that it is, in principle, feasible to collect prospective demographic and clinical data on patients with lung cancer. Legal obligations vary among countries.The European Initiative for Quality Management in Lung Cancer Care has provided the first comprehensive snapshot of lung cancer care in Europe. Executive summaryThis European Respiratory Society (ERS) Task Force report describes the first phase of an ambitious initiative with the ultimate aim to improve the quality of care for people with lung cancer across Europe. The Task Force undertook four projects. 1) An extensive review of the literature on quality management revealed evidence that was mainly limited to individual aspects of quality improvement. 2) A baseline survey of national and local infrastructure of healthcare showed marked differences in resources and access to care among 37 countries. 3) A benchmarking project on the quality of guidelines showed that well-resourced guidelines were better. 4) A feasibility study showed that contemporary clinical data collection was possible through a clinical network representing 28 European countries. The Task Force has created a platform for future research and development of initiatives that may lead to improved care for people with lung cancer in Europe.

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Section: Resultsmentioning

confidence: 99%

The European initiative for quality management in lung cancer care

Blum¹,

Rich²,

Baldwin³

et al. 2014

European Respiratory Journal

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“…The 2016 National Lung Cancer Audit reported that the range of patients with non-small cell lung cancer (NSCLC) who received surgical treatment varied from 5% to 36% across different trusts. 3 Previous studies have also demonstrated that a person can be up to 51% more likely to receive thoracic surgery for lung cancer if they are first diagnosed in a thoracic surgical centre, 14,15 and this effect is most pronounced in surgical centres with the largest lung cancer populations.…”

Section: Stagingmentioning

confidence: 99%

Recent advances in the management of lung cancer

2018

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Thoracic surgery is considered the standard of care for people with early stage lung cancer who are deemed fit enough. Modern Historically, the prognosis for individuals diagnosed with lung cancer has been bleak. However, the past 10 years have seen important advances in treatment and diagnosis which have translated into the fi rst improvements seen in lung cancer survival. This review highlights the major advances in treatments with curative intent, systemic targeted therapies, palliative care and early diagnosis in lung cancer. We discuss the pivotal research that underpins these new technologies/strategies and their current position in clinical practice. KEYWORDS : Lung cancer , curative treatment , targeted therapies , early diagnosis , lung cancer management IntroductionFor several decades lung cancer has been the most common cancer in the world.1 In 2014 there were 46,403 new cases of lung cancer diagnosed in the UK. 2 It is the third most common cancer after breast and prostate, but has the largest proportion of all cancer-related deaths (22%). 2 The overall age standardised incidence has declined slightly over the past 40 years, which is a combination of a marked decline among men and an increase for women (Fig 1 ). Approximately 62% of people have advanced stage disease at diagnosis. 3 When combining all stages of lung cancer in England, 1-year survival has improved from 24.5% in 1995-9 to 36.7% currently. 4 Much of this improvement has occurred since 2010 and is attributed to developments in lung cancer care. StagingIt is important to accurately stage patients with lung cancer as this contributes to treatment options and prognosis. Better access to positron emission tomography with computed tomography (PET-CT) scanning and endobronchial ultrasound (EBUS) for mediastinal lymph node sampling have increased the accuracy of staging for lung cancer. ABSTRACTAuthors:

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“…In a UK regional study (Billing et al, 1996) showed that the mean total delay from presentation to operation for Non Small Cell Lung Cancer (NSCLC) was 109 days. Rich (Rich et al, 2011) also from UK found that resection rates and subsequently survival data were better when patients had easier access to thoracic surgical facilities. In India where conditions are not very different from ours, Chandra (Chandra et al, 2009) found the median symptom to initiation delay to be 185 days.…”

Section: Discussionmentioning

confidence: 97%