Document Detail


Gaps in optimal care for lung cancer.
MedLine Citation:
PMID:  18670305     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Lung cancer is the leading cause of cancer death in Australia, but little is known about how Australian patients with this disease are managed. METHODS: Lung cancer patients diagnosed from November 1, 2001 to December 31, 2002 were identified through the population-based New South Wales Central Cancer Registry. Information was collected on diagnosis, staging, referrals, and treatment. Cross-tabulations and logistic regression examined factors related to not receiving cancer-specific therapy. RESULTS: There were 2931 potentially eligible patients registered by the Central Cancer Registry and completed questionnaires were obtained for 1812 patients (62%); median age 71 years and 66% men. The pathology was non-small cell in 71%, small cell in 15% and not confirmed in 13% of patients. Eleven percent of patients did not see a lung cancer specialist and 33% received no cancer-specific therapy after initial diagnosis. Treatment utilization rates were 17% for surgery, 39% for radiotherapy, and 30% for chemotherapy. Factors significantly associated with having no cancer-specific therapy included female gender, older age, weight loss, poorer performance status, advanced or unknown disease stage, and consultation with a low patient volume lung cancer specialist or a non-lung cancer specialist. The median survival was 172 days and 2-year crude survival was 17%. CONCLUSIONS: Treatment patterns were in broad concordance with present national guidelines. Nevertheless, a significant proportion of lung cancer patients did not receive cancer-specific therapy. Treatment decisions should be multidisciplinary and decision-makers should include experienced lung cancer specialists.
Authors:
Shalini K Vinod; Dianne L O'Connell; Leonardo Simonella; Geoff P Delaney; Michael Boyer; Matthew Peters; Danielle Miller; Rajah Supramaniam; Leslie McCawley; Bruce Armstrong
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer     Volume:  3     ISSN:  1556-1380     ISO Abbreviation:  J Thorac Oncol     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-01     Completed Date:  2008-11-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101274235     Medline TA:  J Thorac Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  871-9     Citation Subset:  IM    
Affiliation:
Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), University of New South Wales, Liverpool Hospital, Liverpool BC, New South Wales, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung / mortality,  pathology,  therapy*
Carcinoma, Small Cell / mortality,  pathology,  therapy*
Child
Child, Preschool
Delivery of Health Care / standards*
Female
Humans
Infant
Infant, Newborn
Lung Neoplasms / mortality,  pathology,  therapy*
Male
Middle Aged
Neoplasm Staging
Patient Care Team / standards*
Practice Guidelines as Topic
Quality of Health Care
Questionnaires
Registries
Survival Rate
Young Adult

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