The RCP conducted a national audit of Lung Cancer in 1997-98. The audit demonstrated large variations in outcomes for patients with lung cancer with a four fold difference in survival between the best and the poorest performing centres. The reasons for this variation were unclear and led to the formation of an informal intercollegiate group under the aegis of the RCP. This group developed a core data set for future lung cancer audits which was published in 1999. This data set included all the essential data items to describe the demographics, stage, presentation and management of patients with lung cancer.

Mortality from lung cancer exceeds that from bowel, breast and prostate cancers combined and is the cause of death for 35,000 people in the UK each year. Sadly, although mortality rates from lung cancer have improved over the last thirty years, the outlook for patients diagnosed with lung cancer is still poor. In the 1970s one year survival was 15% with a five year survival of 1-2%. The most recent data published by Cancer Research UK shows male and female one year survival of 27% and 30% respectively, with corresponding five year survival of 7% and 9%. These figures are poor by international standards where other developed nations such as USA, France and Germany report five year survival rates of up to 10-13%.

Data Collection

The core lung cancer data set has become the basis of the National Lung Cancer audit. This audit, using the LUCADA database (LUng CAncer DAta), began to collect data in England in 2004 with its first full year of data collection in 2005. The audit aims to record outcomes in lung cancer and through risk adjustment, to start to explain the wide variation in outcome still seen in lung cancer.
 
The National Lung Cancer audit is a part of a wider program of national audit run by the Information Centre for health and social Care (the IC). The audit is run in partnership with the Royal College of Physicians and funded by HQIP.

Related content

View the project pages for the the Improving Lung Cancer Outcomes for Patients (ILCOP) project

External links

Support and information for staff

If you are involved in implementing the national Lung Cancer Data Audit (LUCADA)  further information can be found on: 

Publications and Reports

Other useful websites

Contacts

General queries: lucada@ic.nhs.uk

Technical queries: helpdesk@cfh.nhs.uk

 

The Future

Work is ongoing so that further outcomes are produced from the National Lung Cancer Audit to:

  • Translate the huge amount of information collected by the audit into improvements in services and outcomes for patients at a local level. This includes a project funded separately by The Health Foundation.
  • Visit Health Foundation website - Closing the Gap 
  • Keep the audit relevant in the face of changes in practice (for example the introduction of a new staging system)
  • Secure long-term funding for the audit
  • Integrate the dataset in to the new National Cancer Dataset

The importance of national cancer audit is recognised in the National Cancer Plan, cancer peer review and by NICE. For the first time in 2010, NLCA headline indicators were utilised in the so-called “Clinical Lines of Enquiry”. The Healthcare Commission now looks at participation in national audit as a performance indicator in the health checks for NHS trusts, and the NLCA is included in the list of audits for the 2011 Quality Accounts. It is clearly vital that everyone continues to support these important audits so allowing us to understand outcomes in lung cancer and to bench mark individual performance against national standards. In understanding the issues and then addressing the differences between the best and poorer performing areas we will see improved outcomes for lung cancer.
 
Contact us for more details or information about the lung cancer audit or other aspects of the RCP’s lung cancer programme. We would also be pleased to learn of any related ongoing or planned work in cancer units, centres or regions.

Contacts

General queries: lucada@ic.nhs.uk

Technical queries: helpdesk@cfh.nhs.uk

Clinical audit