Introduction
Currently only limited population-based data are available around cancer care and patient outcomes. However, linkage and re-analysis of existing datasets may identify gaps or variations in care and opportunities for improvement.
Aim
A recent use of existing datasets to identify variations in lung cancer care and outcomes in Victoria is described.
Method
In preparation for the inaugural Victorian Lung Cancer Summit, data regarding patient characteristics, management and outcomes were collected to inform discussion. Data sources were registries, hospital administrative data, patterns of care studies and medical record audit. An expert clinical group guided the analysis conducted by NEMICS and Monash staff. The newly published optimal care pathway for lung cancer was used to organise the presentation of data.
Results
Data including the following were presented, generally analysed by geographic region and variation from guidelines: incidence; survival; age; gender; country of birth; smoking; stage; timeliness and reasons for delay; MDM case discussion; surgery and post-surgery survival. Twelve hospitals (41%) had fewer than 10 major lung procedures performed in 2012. Variations in rates of tissue diagnosis and of post-surgery adjuvant chemotherapy in NSCLC, sub-optimal utilisation of radiation therapy and low and variable uptake of formalised supportive care screening were noted.
Discussion
Linkage and re-analysis of existing datasets provided useful information, not previously available, to inform a clinical discussion around identifying potential gaps in care. Further analysis will be required to validate the initial observations and gain a more detailed understanding.
Conclusion
Data extracted from existing datasets were successfully analysed to inform a discussion on improving care and outcomes for lung cancer patients, and earlier also for colorectal cancer. A similar approach may be applied to other tumour streams and in many situations also provides a means to monitor progress on cancer reforms.