NLCA annual report 2016

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The National Lung Cancer Audit report 2016 demonstrates the key findings from the 12th annual audit for lung cancer patients diagnosed in 2015 in England, Wales, Guernsey and Scotland. The purpose of the audit is to review the quality of lung cancer care, to highlight areas for improvement and to reduce variation in practice.

Patient-level booklet

We have produced our first patient-level booklet to help inform lung cancer patients, their families and their carers about the level of care they can expect. Working with the Roy Castle Lung Cancer Foundation we consulted lung cancer patients, their carers and their families to help us write this booklet, which showcases the results from our 2016 annual report.

Key findings of annual report

In our previous annual report (patients diagnosed in 2014), we made recommendations that lung cancer services should set out to achieve, covering data quality, process of care and treatment. Below we report the overall national performance (England, Wales, Guernsey) against these measures. Scotland does not provide individual patient data and therefore is not included in this overall measurement.

More detailed results are reported in the key findings and recommendations section of the annual report.

  • This report covers patients with lung cancer first diagnosed in 2015, and includes 36,025 patients in England, 2,207 in Wales, 37 in Guernsey and 4,884 in Scotland.
  • The new dataset in England has identified more patients and more treatments, but has also identified issues with local completion and submission of performance status and lung cancer nurse specialist data.
  • Incorrect or incomplete local completion and submission of the ‘place first seen’ field has created some difficulties in allocating patients to the correct trust in England, and so the data for individual organisations should be viewed in context.
  • Measures of survival show encouraging improvements, with 1-year survival measured at 38% for this cohort, compared with 31% for the 2010 audit.
  • Pathological confirmation rates have risen to 72% overall (although falling short of the target of 75%), and it is very pleasing that the proportion of lung cancers that are not precisely pathologically subtyped has fallen further to 11%.
  • Inclusion of other sources of data (HES, SACT and RTDS) has revealed more treatments, such that anticancer treatment was given to 60% of patients overall, meeting the previous target of 60%.
  • The proportion of patients undergoing surgery has risen, reaching 16.8% in patients with non-small-cell lung cancer (NSCLC).
  • There has been a significant rise to 64% in the proportion of patients with NSCLC (advanced stage and performance status 0–1) who receive chemotherapy.

There remains wide and unacceptable variation in standards of care between organisations.