Lung cancer patterns of care in south western Sydney, Australia

• Published in: Thorax Vol. 58; no. 8; pp. 690 - 694
• Main Authors: Vinod, S K, Delaney, G P, Bauman, A E, Barton, M B
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and British Thoracic Society 01-08-2003; BMJ Publishing Group Ltd; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adult; Age; Aged; Aged, 80 and over; Analysis; Australia; Cancer therapies; Chemotherapy; Data analysis; Ethics; Evaluation; Female; Health services; Humans; Lung Cancer; Lung Neoplasms - mortality; Lung Neoplasms - therapy; Male; Management; Medical care; Mens health; Middle Aged; Mortality; Multivariate Analysis; New South Wales - epidemiology; Oncology; Pathology; Patient outcomes; patterns of care; Population; Radiation therapy; radiotherapy; Registries; Statistics; surgery; survival; Survival Analysis; New South Wales; Australia
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thorax.58.8.690

Background: Lung cancer is the leading cause of cancer deaths in New South Wales (NSW). There is a significantly higher incidence of lung cancer in the South Western Sydney Area Health Service (SWSAHS) than the NSW average. The aim of this study was to document patterns of lung cancer care for SWSAHS residents. Methods: SWSAHS residents diagnosed with lung cancer in 1993 and 1996 were identified from the NSW Central Cancer Registry and their medical records reviewed. Results: The study population comprised 527 patients of median age 68 years. 12% did not see a lung cancer specialist, 9% did not have a pathological diagnosis, and 28% did not receive any active treatment throughout the course of their illness. The median survival was 6.7 months and the 5 year overall survival was 8% (95% CI 6 to 10). The rates of pathological diagnosis, specialist referral, and treatment decreased with older age and poorer performance status. Conclusions: The management of lung cancer patients in SWSAHS is suboptimal. A significant proportion of patients are not receiving treatment. To improve patient care and outcomes, all lung cancer patients should be referred to a specialist for management, ideally in a multidisciplinary setting. Both consumers and general practitioners need to be educated about options available for the management of lung cancers and ageist and nihilistic attitudes need to be overcome.