Dr She Lok, Dr David Greenberg, Barbara Gill, Andrew Murphy, Dr Linda McNamara

Transcription

1 Dr Sh Lok, Dr David Grnbrg, Barbara Gill, Andrw Murphy, Dr Linda McNamara This is a joint working projct btwn Mount Vrnon Cancr ntwork and Roch Products Ltd. 1 Introduction Dscrib th work that Mount Vrnon Cancr Ntwork has bn doing with ECRIC Prsnt th data that has bn producd during this tim Undrstand factors that hav drivn highr than avrag incrass in survival rats Undrstand th diffrncs in rsult btwn ECRIC and LUCADA 2 1

2 MVCN consists of thr Trusts which covrs Hrtfordshir, Luton and South Bdfordshir East & North Hrtfordshir NHS Trust Wst Hrtfordshir NHS Trust Luton & Dunstabl NHS Foundation Trust Oncological srvic is providd by Mount Vrnon Cancr Cntr Surgical srvic is providd by Harfild or Papworth hospitals Th Ntwork has bn working with ECRIC, Roch and NCIN to analys th lung cancr data for th last 3 yars 3 4 2

3 Th collaboration startd in 2009 as a rsult of th Ntwork s concrn with rgards th data analysis that was coming from LUCADA (NLCA): Wr th Trusts data compltnss in qustion? Was th data uploadd accurat? Is ECRIC abl to validat th data analysis from LUCADA? Additionally, th Ntwork was awar that th survival rats for lung cancr placd it in th bottom/fourth quartil whn compard to othr Ntworks in England 5 6 3

4 7 Changs in 1-yar survival rats ovr tim - ECRIC Plas not rst of East of England includs Anglia Cancr ntwork; Essx Cancr Ntwork and Princss Alxandra Hospital 8 4

5 250 Mdian survival NLCA (2010) Survival (days) Ntwork NLCA - Survivd 1-Yar aftr diagnosis P r c n t a g Ntwork 10 5

6 Rviwing procss and clinical masurs During th priod in qustion thr has bn a numbr of issus idntifid: Diffrncs btwn diffrnt data rports (NLCA and ECRIC) rviw of 2009 and 2010 Activ Tratmnt (surgry, radiothrapy, chmothrapy) Compltnss of data Staging Histological diagnosis ECRIC = Eastrn Cancr Rgistration and Information Cntr; NLCA = National Lung Cancr Audit 11 Plas not with NLCA data, th numbr of NSCLC cass at Stag IIIB or IV ar for patints with PS 0-1, similar data in trms of PS status is not availabl from ECRIC. Additionally staging data for ERCIC is for Stag III-IV only 12 6

7 ECRIC assigns cass to a Ntwork basd on post cod LUCADA assigns cas to a Ntwork basd on th upload from th rlvant MDT. Diffrnc within a Ntwork could b rfrral pattrn but th diffrnc is sn vn within th East of England (though smallr) Plas not with NLCA data, th numbr of NSCLC cass at Stag IIIB or IV ar for patints with PS 0-1, similar data in trms of PS status is not availabl from ECRIC. Additionally staging data for ERCIC is for Stag III-IV only 7

8 Plas not with NLCA data, th numbr of NSCLC cass at Stag IIIB or IV ar for patints with PS 0-1, similar data in trms of PS status is not availabl from ECRIC. Additionally staging data for ERCIC is for Stag III-IV only Plas not with NLCA data, th numbr of NSCLC cass at Stag IIIB or IV ar for patints with PS 0-1, similar data in trms of PS status is not availabl from ECRIC. Additionally staging data for ERCIC is for Stag III-IV only 8

9 Plas not with NLCA data, th numbr of NSCLC cass at Stag IIIB or IV ar for patints with PS 0-1, similar data in trms of PS status is not availabl from ECRIC. Additionally staging data for ERCIC is for Stag III-IV only Plas not with NLCA data, th numbr of NSCLC cass at Stag IIIB or IV ar for patints with PS 0-1, similar data in trms of PS status is not availabl from ECRIC. Additionally staging data for ERCIC is for Stag III-IV only 9

10 Prcnt of diagnoss Btwn 2007/08 and 2009/10 - ECRIC 19 Activ tratmnt (surgry, radiothrapy or chmothrapy) rats for lung cancr 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Mount Vrnon CN Rst of EofE Ara of rsidnc at diagnosis No activ tratmnt Activ tratmnt 20 10

11 Prcnt of diagnoss Staging Compltnss NLCA Mount Vrnon CN P r c n t a g Yar 21 Intgratd TNM stag at diagnosis for lung cancr 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% Stag not known Stag 4 Stag 3 Stag 2 Stag 1 0% Mount Vrnon CN Rst of EofE Ara of rsidnc at diagnosis 22 11

12 Prcnt of diagnoss Histological confirmation NLCA Mount Vrnon CN P r c n t a g Yar 23 Histological confirmation of cancr rgistration for lung cancr 100% 90% 80% 70% 60% 50% 40% No histology Histology 30% 20% 10% 0% Mount Vrnon CN Rst of EofE Ara of rsidnc at diagnosis 24 12

13 Summary ECRIC asssss on th plac of rsidnc but NLCA assss th patints assssd in th MDT. Thr ar diffrncs idntifid with NLCA and ECRIC data. Ovrall: 15% diffrnc btwn numbr of cass hld by ECRIC vs. NLCA (2010 data) Particularly with th assssmnt of survival mtrics In trms of rlativ survival rats, looking at impact of tratmnt Mdian survival looking at proportion of patints dying fastr Diffrnt masurs with diffrnt paramtrs so no comparabl 25 Consistncy in trms of paramtrs Survival in Mount Vrnon Cancr Ntwork has bn improving ovr th last 4 yars and caught up with th rgional and national avrags

14 Conclusion Data compltnss is ssntial for appropriat analysis to b don. Consistncy is rquird in trms of analysis and approach with th data. Th survival is du to combination of factors including data compltnss, improvmnt in activ tratmnt (notably chmothrapy for lat stag NSCLC) and has spurrd on improvmnt in staging and histological diagnosis. NSSG continuing to rviw procss and clinical masurs against survival. 27 Acknowldgmnts MVCN and lung cancr MDTs All th staff of th Eastrn Cancr Rgistration and Information Cntr 28 14

15 Qustions? 29 15