ONCOLOGY
It is very encouraging to note that overall many of our audit indicators have improved compared to the last report.
managers, chief executives and commissioners. These relate to three main areas – data completeness, process of care, and treatment and outcomes – all of which are aimed at supporting lung cancer services to continue in improving care on a regional and national level. Key recommendations include: l Pathological confirmations below 80% should be reviewed to ensure that best practice has been followed.
l At least 90% of all patients should be seen by a lung cancer nurse specialist (LCNS) and 80% of patients should also have an LCNS present at the time of diagnosis (the report indicates that only 57% of patients were seen by an LCNS).
l Multidisciplinary teams (MDTs) with anti-cancer treatment rates of below 60% should conduct detailed casenote reviews to identify why patients did not receive anti-cancer treatment.
l MDTs with one-year survival rates of less than 38% should review their diagnostic and treatment pathways to ensure that all patients are diagnosed promptly and treated appropriately.
Ian Woolhouse, NLCA senior clinical lead, said: “It is very encouraging to note that overall many of our audit indicators have improved compared to the last report. Highlights include the improvement in pathological sub-typing of lung cancer, the use of chemotherapy and surgery in non-small-cell lung cancer, and probably most importantly the improvement in one-year survival. “However, there is still much work to do to ensure that all lung cancer patients receive a standard of care that is equal to the best in the country and we implore all lung cancer units to critically review their results and work with our quality improvement team to achieve this.” Dr Jesme Fox, medical director of the Roy
Castle Lung Cancer Foundation, said: “The NLCA is a great source of information on lung cancer. It is really important that we monitor services, and lung cancer patient outcomes, in a timely manner. This audit allows us to do that. “We are pleased to see this encouraging increase in patient survival. However, there is much still to do to ensure that lung cancer patients are diagnosed as early as possible and are able to access best practice treatment and care.”
New blood test could lead to earlier detection
A new blood test has been developed that can accurately detect antibodies to lung cancer cells at an early stage, potentially up to five years before traditional scans show any damage. The early results of the largest ever randomised trial for lung cancer screening using the blood test in a population of approximately 12,000 high risk participants, were presented at the British Thoracic Society (BTS) Winter Meeting (December 2016). Nearly one in 10 (9.8%) of the group who received the blood test (approximately 6,000 people at higher risk of lung cancer) had results indicating antibodies present. These individuals were then investigated further with a chest X-ray and serial CT scans to look for signs of lung cancer. To date, 16 cases of lung cancer have been diagnosed; three quarters of these were at an early stage. This is higher than expected from current clinical experience. Although these results are encouraging, it is too early to say whether the study will change clinical practice as the final results will only be available once data from participants in the control group
CSJ
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