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Fifty per cent rise in lung cancer surgery in five years

Gaps between providers narrowing but postcode lottery still exists

Ingrid Torjesen

Monday, 23 May 2011

The percentage of lung cancer patients who have lung cancer surgery in the UK has increased by over 50 per cent in the past five years, according to the most comprehensive audit ever of the disease.

About one in seven patients – over 4,500 people every year – now has surgery compared to just one in 11 five years ago, according to the National Lung Cancer Audit 2010 produced by the NHS Information Centre in partnership with the Royal College of Physicians.

Lung cancer, which kills more people in the UK than any other form of cancer, is often diagnosed at an advanced stage, which means a substantial proportion - up to three quarters - of patients are not suitable for surgery. However the improved surgery rate suggests increasing surgical expertise and access to more complex surgical techniques is opening up surgery to patients of borderline fitness.

The audit, containing data for almost 100 per cent of the 37,600 lung cancer cases presenting to secondary care to have been first treated in 2009, shows that the percentage of patients receiving key care measures, such as surgery or anti-cancer treatment like chemotherapy or radiotherapy is improving, but still varies from provider to provider. The ranges are 9.8 per cent to 16.3 per cent for surgery, 54.0 per cent to 66.5 per cent for any active anti-cancer treatment, 74.2 per cent to 91.5 per cent have a CT scan before undergoing bronchoscopy, 70.9 per cent to 85.2 per cent are diagnosed by tissue biopsy, and 52.7 per cent to 79.8 per cent of patients with Small Cell Lung Cancer receive chemotherapy.

The gap between the highest and lowest performing provider is narrowing, as is the gap between the UK and other countries in Western Europe that have historically been rated as having higher quality care.

Dr Mick Peake, audit clinical lead and clinical lead for NHS Cancer Improvement and the National Cancer Intelligence Network, said there was clear evidence that standards of care were improving and argued that the audit process itself was one of the main factors behind this. “Wide variation still exists, however, in the standard or care between different hospitals and we need to continue to strive to bring the care in all units up to the standard of the best,” he said.

Dr Rosemary Gillespie, chief executive of The Roy Castle Lung Cancer Foundation, said: "Marked geographical variation in the treatment and care for lung cancer patients, still exists across the UK. Where you live in the country should not determine what treatment you receive, it should be based on need, not postcode.

"And while we are pleased to see some improvements, the real improvement we would like to see is in survival rates, which still remain low.

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