Lung cancer is the highest cause of cancer death in Queensland with the 5–year relative survival improving only slightly over the last 20 years from 12% to 17%. Although monitoring of surgical outcomes for persons with early stage lung cancer has been embedded into the cancer quality and safety program for Queensland, the majority of persons with lung cancer receive treatment such as chemotherapy, radiotherapy or best supportive care. Further analysis and monitoring of access to treatment, evidence based practice guidelines, variation in clinical practice is required to understand lung cancer treatment patterns and outcomes.
We analysed patterns of treatment of all Queensland residents who were diagnosed with lung cancer (n=11,155) between 2010 and 2014. The rates of major resection (19%), radiotherapy (50%) and IV systemic therapy (43%) were calculated using data from the Queensland Oncology Repository (QOR). Multivariate logistic regression was used to model the variation in treatment rates due to age, residence at diagnosis, socioeconomic status, cancer stage and indigenous status. Post treatment mortality and survival was calculated following major resection, IV systemic therapy and radiotherapy.
Currently 82% of persons with lung cancer receiving major resection survive 2 years after surgery which compares favourably with national and international surgical survival rates. There is wide variation across Queensland regarding time to surgery with 69% (57%-94%) receiving surgery within 45 days of diagnosis. Further analysis will be presented with comprehensive clinical variables to explore 30 day mortality following major resection, chemotherapy and radiotherapy and differences among rural and remote person with lung cancer within Queensland public and private hospitals.
Analysis of population wide data and peer facility comparisons facilitate focused attention on good performance and highlight areas where more attention is needed to continue to provide Queenslanders with safe, accessible, equitable and effective care.