Steep rise in lung cancer surgery

23rd May 2011 - The number of lung cancer patients who undergo surgery for the disease has increased by over 50% in five years, according to a comprehensive audit.

About one in seven patients - over 4,500 people every year - now has surgery compared to about one in 11 five years ago, according to the National LungCancer Audit 2010.

The analysis was commissioned by the Healthcare Quality Improvement Partnership and carried out by the NHS Information Centre and the Royal College of Physicians.

Lung cancer kills more people in the UK than any other type of cancer. It is responsible for nearly a quarter (24%) of all male cancer deaths and more than a fifth (21%) of female cancer deaths.

Earlier diagnosis

The increase in life-saving surgery is being attributed to earlier diagnosis of the disease. Historically, lung cancer is often diagnosed at an advanced stage which means that many patients - up to three quarters - are not suitable for surgery. This may be because they are elderly or because they have other medical complications.

The five year rise in surgery rates suggests that more clinical teams have developed the expertise to assess patients who may be borderline fit for undergoing surgery and have knowledge of more complex surgical techniques to deal with other medical conditions.

The audit also shows that the percentage of patients receiving important care, such as surgery or anti-cancer treatment like chemotherapy or radiotherapy is improving, but still varies from provider to provider. For instance, the percentage of people undergoing surgery for lung cancer varied between 9.8% and 16.3% depending on which area they lived.

Regional variations

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

Dr Mick Peake, a consultant in respiratory medicine, who led the audit team, said in a statement: "It is a tribute to the ongoing work of all the lung cancer specialist teams across the country that we now have such excellent data on the care of lung cancer patients in the UK. We also now have clear evidence that standards of care are improving and we believe that the audit process itself is one of the main factors behind this."

Reaction

Cancer charities welcomed the announcement that more patients were receiving surgery. However, they expressed concern over the regional variations in cancer care.

Dr Rosemary Gillespie, chief executive of The Roy Castle Lung Cancer Foundation, said in an emailed statement: "Where you live in the country should not determine what treatment you receive. It should be based on need, not postcode."

Gillespie added: “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."

Dr Lesley Walker, director of cancer information at Cancer Research UK, described the variations in care across the UK as "worrying".  Walker added in a statement: “The amount of data now available is impressive and will undoubtedly help to reduce this variation. Audits like this have played a pivotal role in improving cancer care over the last decade. This lung cancer audit will be important in helping the UK survival rates for the disease match the best in the world.”