Variations in lung cancer treatment may be limiting survival in England, according to a new study.
Surgery, radiotherapy and chemotherapy rates vary across England, and survival is best where they are highest. Differences in factors like patient age or sex didn’t.
Professor Charles Swanton, Cancer Research UK’s chief clinician, said the useful analysis suggests there’s important work to be done to bring all UK regions up to the highest standards of care to improve treatment for lung cancer.
Lung cancer survival in England lags behind comparable high income countries, and there are differences across England.
The study, published in the journal Thorax, looked at 176,225 lung cancer patients diagnosed between 2010-14. The researchers compared differences in patient characteristics, tumour features and treatment with patient survival.
They found large differences in the proportion of lung cancer patients receiving different treatments in different areas:
- Between 4-13% of patients received radiotherapy
- Between 9-17% of patients received surgery
- Between 22-35% of patients received chemotherapy.
The researchers said that the differences weren’t due to factors like age or tumour stage, but were probably down to differences in doctors’ preference.
Patients in areas with higher radiotherapy and surgery rates were more likely to be alive after 2 years. While this wasn’t the case for chemotherapy, patients treated in this way were still more likely to be alive after 6 months.
The researchers found that if treatment standards across the country matched the top performing regions, up to 800 deaths could be avoided each year.
Swanton said that earlier diagnosis will play a major role in improving outcomes for lung cancer patients, on top of improving access to treatment.
“The NHS in England should continue to strive to overcome this devastating disease and provide patients with access to the best, evidence-based treatments regardless of where they live,” he said.
Moller, H. et al. (2018) Geographical variations in the use of cancer treatments are associated with survival of lung cancer patients. Thorax