Author of

• 12824

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  P3.21 - Poster Session 3 - Diagnosis and Staging (ID 171)

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

  • 12827

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    P3.21-003 - The LungPath Study: Variation in lung cancer diagnostics in England. Does the availability of PET scanning and EBUS affect patient care? (ID 1429)

    09:30 - 09:30  |  Author(s): G. Santis
    • Abstract

    Background
    The LungPath study is a national multi-centre survey of lung cancer diagnosis and staging practice in England. As part of the project, we looked for variation in access to key investigations such as EBUS and PET-CT scanning and linked this to how likely these studies were used to be in different centres and the impact these differences may have on patient care.

    Methods
    Twenty willing English lung cancer centres were randomly selected to participate in the LungPath study. Participating centres agreed to submit data on each new lung cancer patient seen during the study period of six months from January to June 2012. Data collected included clinical information such as age, gender and performance status, the dates of all radiological investigations performed and anonymised pathology reports from all other investigations performed. The data collected was used to map each individual patient’s diagnostic pathway. In addition, we collected information about typical waiting times for key investigations and whether these investigations were available on-site or at other institutions. We analysed the patient data to see if the availability of investigations such as EBUS and PET-CT impacted the patient pathways in each centre.

    Results
    There were significant differences between centres in the availability of EBUS and PET-scanning. Approximately half of the units surveyed reported waiting times for EBUS and PET-scanning of one week or less while the other half reported longer waits, typically two weeks and sometimes longer. There were large differences in the proportions of patients that underwent EBUS or PET-scanning from centre to centre with patients up to six times more likely to receive an EBUS and four times more likely to receive a PET-scan in some centres than others. There was a clear relationship between the use of the investiagtion and the waiting time. We also found that the point in the diagnostic pathways that these investigations were used varied and in many cases differed from best practice guidelines; several centres routinely performed EBUS as a separate procedure after a bronchoscopy had already been performed.

    Conclusion
    There are marked differences in the availability and use of EBUS and PET-scanning within different lung cancer units involved in diagnosing and staging lung cancer in England. There is a need for commissioners to ensure fairer service provision across England and opportunities for education of clinicians to make best use of the available resources.