Dr Susan Harden, clinical lead for the National Mesothelioma Audit highlights some key findings from the recently published NMA report.
There were 7,210 new cases of mesothelioma (6,950 with malignant pleural mesothelioma (MPM) and 260 with peritoneal mesothelioma (PM)) diagnosed between 1 January 2016 and 31 December 2018.
Data completeness for MPM has improved since the previous audit (2014–16) for performance status (PS) (increased to 81% from 69%), stage (increased to 65% from 54%) and clinical nurse specialist (CNS) data completeness (increased to 78% from 67%), and data completeness for all measures were improved for PM. This was due to improvements in data completeness for England with data completeness for Wales remaining excellent.
Diagnostic and support measures have improved since the previous audit: the proportion of MPM mesothelioma patients discussed by a multidisciplinary team (MDT) had increased (89% from 81%), CNS assessment had increased (70% from 54%), and the proportion of pathologically diagnosed cases with non-specific histologic subtyping had reduced (31% from 36%). The proportion of English PM patients referred to the national peritoneal MDT had doubled (28% from 14%).
Use of systemic anticancer therapy (SACT) and radical debulking surgery for MPM remained stable at 40% and 5% respectively. There was a reduction in the use of radiotherapy to 15% (from 22%). Use of SACT for PM had increased to 44% (from 41%).
Long-term 3-year overall survival had increased for both MPM (10% from 7%) and PM (18% from 15%) compared with the previous audit report.
Within the trend of steadily improving results at national level, there still remains unexplained and unwarranted variation across different regions including in the use of active treatment and histologic subtyping for mesothelioma and access to CNS support. In addition to the report itself, an online bespoke dashboard is provided for each individual organisation, highlighting their results against the national average to enable analysis and evaluation for quality improvement by local teams.
I would like to thank everyone who has contributed to this report, including the project team, our partners, all MDTs and their patients. Looking to the future, in this time of uncertainty, I hope that the next National Mesothelioma Audit report will achieve its aim to become fully national with the inclusion of data for Scotland too.
Dr Susan Harden
Clinical lead for the National Mesothelioma Audit