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Title: No improvement in lung cancer care: the management of lung cancer in 1996 and 2002 in New South Wales
Authors: Simonella L; Hui A; Armstrong B; O'Connell DL; Vinod SK; Delaney GP; Boyer M; Esmaili N; Hensley M; Goldsbury DE; Supramaniam R
Categories: Cancer Control, Survivorship, and Outcomes Research - Resources and Infrastructure
Cancer Type - Lung Cancer
Keywords: Australia; Odds Ratio; pathology; Patterns of care; Research; therapy; Wales; cancer; Comparative Study; diagnosis; epidemiology; Lung; Medical Records; methods; New South Wales
Year: 2009
Journal Title: Internal Medicine Journal
Volume: 39
Issue: 7
Page number start: 453
Page number end: 458
Abstract: BACKGROUND: Patterns-of-care studies emphasize significant variation in the management of lung cancer. The aim of the study was to compare the patterns of care for patients diagnosed with lung cancer in 1996 and 2002 within three health areas in New South Wales. METHODS: Treatment data were collected from medical records and treating doctors for the calendar year 1996 and between 1 November 2001 and 31 December 2002. Patients were residents of either south-western Sydney, Hunter or Northern Sydney health areas at the time of diagnosis. chi(2)-tests were used to investigate changes in treatment patterns between the two time periods. An adjusted odds ratio for treatment in 2002 relative to 1996 was calculated using logistic regression. RESULTS: Data were available for 738 and 567 cases in 1996 and 2002, respectively. Cancer-specific therapy was given within 6 months of diagnosis to 62 and 64% of patients, respectively. Adjusting for health area, age, sex, pathology and performance status, the odds ratio (OR) of treatment in 2002 relative to 1996 was 1.03 (95% confidence interval (CI) 0.78-1.35). When stage was included, the odds of treatment in 2002 relative to 1996 for non-small-cell lung cancer (n = 950) was 1.21 (95%CI 0.87-1.68). After adjustment for potential confounders, patients diagnosed with small-cell lung cancer (n = 176) were substantially less likely to receive treatment in 2002 compared with patients diagnosed in 1996 (OR = 0.11; 95%CI 0.04-0.34). CONCLUSION: The odds of receiving treatment in 2002 and 1996 were similar. However, patients diagnosed with small-cell lung cancer in 2002 were significantly less likely to receive treatment. Overall, this study suggests there has been no change in lung cancer care in New South Wales. Further work is required to determine what proportion of persons with lung cancer should receive cancer-specific treatment so that clinical practices can be judged appropriately
Programme: Health Services Research; Lung Cancer
Division: Cancer Research Division
Appears in Collections:Research Articles

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