Lung cancer: the importance of seeing a respiratory physician

• Published in: The European respiratory journal Vol. 21; no. 4; pp. 606 - 610
• Main Authors: Fergusson, R.J, Thomson, C.S, Brewster, D.H, Brown, P.H, Milroy, R, on behalf of Scottish Cancer Trials Lung Group and Scottish Cancer Therapy Network
• Format: Journal Article
• Language: English
• Published: Leeds Eur Respiratory Soc 01-04-2003; Maney
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Chi-Square Distribution; Clinical Competence; Female; Health Services Accessibility; Humans; Lung Neoplasms - diagnosis; Lung Neoplasms - therapy; Male; Medical sciences; Middle Aged; Pneumology; Practice Guidelines as Topic; Pulmonary Medicine; Registries; Tumors of the respiratory system and mediastinum; Human; Lung disease; Prognosis; Respiratory disease; Lung cancer; Stage classification; Malignant tumor; Bronchopulmonary; Recommendation; Treatment; respiratory physician. survival. treatment; Professional practice; Bronchus disease; Diagnosis; Medical specialty
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/09031936.03.00060803

Patients with lung cancer present to and are managed by a variety of clinicians. In this study the effect of involvement by a respiratory physician on the diagnosis, staging, treatment and survival of a large unselected group of lung cancer patients was investigated. The study population was derived from the Scottish Cancer Registry. A total of 3,855 patients diagnosed during 1995 with lung cancer were studied. The data were validated and supplemented by references to medical records. The study found that a respiratory physician had been involved in the initial management of 2,901 (75.3%) patients. These patients were found more likely to have had the cancer diagnosis confirmed by histological methods and to have received active treatment with surgery, radiotherapy or chemotherapy. Survival, 1 yr after diagnosis was higher in patients who saw a respiratory physician (24.4 versus 11.1%) and benefit was found to have remained 3 yrs after diagnosis (8.1 versus 3.7%). Although the patients who had not seen a respiratory physician were generally older, and had more extensive disease, after correcting for age, stage and other prognostic factors, the relative hazard ratio of death for those not managed by a respiratory physician was 1.44. The data from this study supports the recommendations of recent lung cancer guidelines for the early involvement by a respiratory physician.