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Surgery to treat common lung cancers rises by nearly sixty per cent over five years

Median average survival time up by 16 per cent

*Regional information available from this report

4 December, 2013: More than one in five patients with a group of common lung cancers6 underwent surgery in 2012, compared to one in seven in 2008, a new audit shows.

Just over half (51.9 per cent) of the 40,200 lung cancer patients in England and Wales covered by the National Lung Cancer Audit were confirmed7 as having "non small cell lung cancer", for which surgery offers the best chance of a cure when caught early enough8. Among these patients, 22 per cent had surgery as part of their treatment, compared to 14 per cent in 2008.

National Lung Cancer Audit: 2012 Patient Cohort published today highlights this increase as an important measure of the quality of care for lung cancer patients. Historically, the low number of patients undergoing surgery relative to other Western European healthcare systems has been considered as part of the explanation for poorer survival of lung cancer patients in the UK.

The audit also shows that median average time that lung cancer patients survive from the date that they are first seen in secondary care increased by 16 per cent over five years to 221 days, compared to 191 days in 2008. More than half (55 per cent) of patients survived for six months and 39 per cent survived for a year.

The report also highlights that although regional variation in lung cancer treatment and outcomes remains, these differences are narrowing on some measures. For instance, one measure looks at how many lung cancer patients receive any type of anti-cancer treatment9 and examines the gap between the proportions receiving treatment in the upper and the lower quartile of trusts5. In 2011 this gap stood at 10.7 percentage points, by 2012 it had narrowed to 8.5 points.

The audit is managed by the Health and Social Care Information Centre in partnership with the Royal College of Physicians and commissioned by the Healthcare Quality Improvement Partnership as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). The structure of the audit report has been adjusted this year with the aim of making its findings more accessible to a wider range of people, including patients.

Based on audit data for patients first seen in 2012, today's report also shows that in England and Wales:

  • The percentages of patients with confirmed non small cell lung cancer patients undergoing surgery varies between the 30 cancer networks in England and Wales10, from 15 to 31 per cent.
  • The median survival time varies between cancer networks from 179 to 280 days.
  • There has been an increase in the proportion of patients seen by a Lung Cancer Nurse Specialist11 to 82.3 per cent, compared to 79.5 per cent in 2011.
  • The audit has collected data on an estimated 98 per cent of the expected number of new lung cancer cases.

Consultant in Respiratory Medicine Dr Mick Peake, audit clinical lead and clinical lead for the National Cancer Intelligence Network, said:"It is encouraging to see that hospital teams all over the country have responded to the findings and recommendations of previous National Lung Cancer Audits. The rise in the proportions of patients undergoing surgery means that lives are being saved and longer survival times are giving patients more precious time with family and friends.

"I'm pleased to say that extent to which care varies from region to region is reducing on some measures, however it is vital that all clinicians involved in lung cancer to look really carefully at what they are doing and learn best practice from others where they can."

The full report is available here: http://www.hscic.gov.uk/catalogue/PUB12719

ENDS


Notes to editors

1. The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). The trusted source of authoritative data and information relating to health and care, HSCIC plays a fundamental role in driving better care, better services and better outcomes for patients. It supports the delivery of IT infrastructure, information systems and standards to ensure information flows efficiently and securely across the health and social care system to improve patient outcomes. Its work includes publishing more than 130 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.

2. The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP hosts the contract to manage and develop the National Clinical Audit and Patient Outcomes Programme (NCAPOP). Their purpose is to engage clinicians across England and Wales in systematic evaluation of their clinical practice against standards and to support and encourage improvement in the quality of treatment and care. The programme comprises more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions.

3. The Royal College of Physicians (RCP) plays a leading role in the delivery of high quality patient care by setting standards of medical practice and promoting clinical excellence.  We provide physicians in the United Kingdom and overseas with education, training and support throughout their careers.  As an independent body representing over 29,000 fellows and members worldwide, we advise and work with government, the public, patients and other professions to improve health and healthcare.

4. In this press release, numbers over 1,000 are rounded to the nearest 100, percentages are rounded to the nearest whole number.

5. Every Trust or Health Board in England and Wales and Scotland have participated in the audit, although because of differences in reporting schedules, standards and targets the Scottish data are tabulated separately. Guernsey has also participated in the audit. Unfortunately, the Northern Ireland data was not available in time to be included in this report and therefore will be published electronically at a later date

6. There are several different types of lung cancer and these are divided into two main groups: small cell lung cancer, which often spreads quite early on, is typically less likely to be treated with curative surgery; and non small cell lung cancer, which typically has more potential to be treated with curative surgery.

7. Where diagnosis of the cancer and type of cancer is confirmed through histological (tissue) or cytological (cellular) specimen rather than based on clinical or radiological features only.

8. Surgery is considered to be the treatment of choice for patients with stage I-II NSCLC. Careful preoperative assessment of the patient's overall medical condition, especially the patient's pulmonary reserve and cardiac status is critical in considering the benefits of surgery. More on the four stages of lung cancer here: http://www.nhs.uk/Conditions/Cancer-of-the-lung/Pages/Diagnosis.aspx

9. This measures patients having treatments for lung cancer that have an effect on the tumour itself, not just on symptoms. In lung cancer patients these are most often surgery, chemotherapy, radiotherapy or a combination.

10. The data collected in this report is for patients first seen in the calendar year 2012. At this time the Cancer Networks were still in place and responsible for helping to facilitate cancer services in the areas they served therefore the audit has decided to report by Network for this year. Moving forward into 2013 the report will be modified to reflect the new commissioning structures.

11. Clinical Nurse Specialists were introduced in 1995, and they play a vital role in the delivery of high quality care and treatment to patients with lung cancer. It is recommended that all patients should have equitable access to a Lung Cancer Nurse Specialist at the time of diagnosis to guarantee that their physical, social and emotional needs, and their treatment options are appropriately assessed and discussed from the beginning of their cancer journey.

12. For media enquires or to request an interview with a clinical lead about the audit, please contact the HSCIC press office at mediaenquiries@ic.nhs.uk or 0845 257 6990

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