Source: Annual Congress 2009 - Epidemiology and management of lung cancer

Abstract

Introduction
Lung cancer survival in the UK is poor compared with Europe. LUCADA was established in 2004, and is now the largest dataset of lung cancer patients in the UK, but the level of contribution from individual NHS Trusts is variable.
Aim
To determine whether the information within LUCADA is affected by local levels of reporting, and hence whether the dataset as a whole is valid.
Methods
We used both Office of National Statistics cancer registry data and Hospital Episode Statistics to estimate the expected number of lung cancer cases per trust. We then calculated an observed (LUCADA)/expected ratio for each trust and stratified these into quartiles. We compared median survival between these trust strata, and used Cox regression to assess if trust strata (based on case ascertainment) affected survival.
Results
Our dataset included over 65,000 people with lung cancer and overall their median survival was 217 days (Inter Quartile Range 72-566 days). The top three trust quartiles had median survivals of 210 days (68-549 days), 211 days (69-551 days), and 210 days (70-542 days) respectively. The median survival in the lowest quartile was slightly longer at 242 days (88-591 days). The results of our Cox regression analysis showed that survival was very similar in the top 3 quartiles (which contained 91% of our cohort), even after adjusting for age, sex, histology, stage and performance status – and were only marginally better in the quartile with the lowest level of case ascertainment.
Conclusion
The median survival of people with lung cancer included in LUCADA does not appear to be biased by the level of case ascertainment in each trust.

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Citations should be made in the following way:
A. Rich, L. Tata, C. Free, M. Peake, P. Beckett, R. Stanley, D. Baldwin, R. Hubbard (Nottingham, Leicester, Burton-on-Trent, Leeds, United Kingdom). Lung cancer survival in the UK: are the results from the national lung cancer audit (LUCADA) dependent on completeness of case reporting?. Eur Respir J 2009; 34: Suppl. 53, 4687

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