Author of

• 11929

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  P2.22 - Poster Session 2 - Epidemiology, Etiology (ID 167)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Prevention & Epidemiology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11938

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    P2.22-009 - Quality in lung cancer care: The development of a population based lung cancer registry (ID 2536)

    09:30 - 09:30  |  Author(s): J. McNeil
    • Abstract

    Background
    Lung cancer is the fourth most common cancer in Victoria and the leading cause of cancer mortality. Little local knowledge exists of the factors which influence outcome in lung cancer. A pressing need exists to describe regional structure, process and outcome in lung cancer care to improve quality of care and to inform translational research and health care planning. We aim to develop and pilot a population-based lung cancer clinical quality registry to describe clinical assessment, diagnosis, staging, management and outcomes in lung cancer in Victoria.

    Methods
    The establishment of the Victorian Lung Cancer Registry Pilot Project commenced with the appointment of a Steering Committee to provide project governance. Review of current literature and evidence-based national and international clinical practice guidelines was undertaken by an expert working group. Included data items were epidemiologically sound, reproducible and valid. The data set enables the capture of identified quality indicators designed to describe the structural quality, process quality and indicators of outcome in lung cancer management. Case ascertainment is derived from institutional ICD-10 coding of small and non-small cell lung cancer. Consent to recruitment to the registry occurs via an “opt-off” system. Follow up and outcome measures are collected 6 and 12 months after initial diagnosis capturing survival, treatment and quality of life assessments. Survival will be reconfirmed at 2 and 5 years post diagnosis. Institutional recruitment was designed to sample from metropolitan public, metropolitan private and regional hospitals. A quantitative, case finding audit was employed to evaluate the case ascertainment methodology at a major metropolitan hospital.

    Results
    Ethics approval was received for 8 pilot sites and a mechanism for rapid case ascertainment and secure data transfer has been established. A web enabled data collection tool has been developed and data has been collected on 576 eligible and consenting patients. Evidence of distress screening was available for 13.02% of subjects. Diagnosis was confirmed < 28 days from referral in 56-86% of cases across institutions. A statement of ECOG status was available in 52.51% of cases and clinical T staging in 48.43% prior to treatment. A record of multidisciplinary team meeting presentation was available in 48.43% of cases. Curative surgery was provided for 27.78% of subjects, curative chemotherapy <5% and curative radiotherapy < 5%. Curative surgery was provided < 14 days from diagnosis in 82-100% of cases. 30 day post curative surgery mortality was 3.12% following 160 curative surgical procedures.

    Conclusion
    Cancer registries have proven capacity for improving process in the delivery of cancer care and the ensuing outcomes. The development of rapid case ascertainment and “opt off” recruitment strategies appear viable and should ensure broad recruitment from eligible patients diagnosed with lung cancer in Victoria. For registries to inform quality of care and benchmark performance, high quality data is needed on all eligible cases. Our study has identified significant gaps in the documentation of this information in the patient’s medical record. Efforts to improve documentation are required to ensure that registries can perform their important function.