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Early diagnosis ‘not only factor’ in lung cancer outcome

Better outcomes for patients with lung cancer may have more to do with access to chemotherapy and surgery rather than early detection and referral by GPs, a new study suggests.

The comparison of lung cancer survival rates between five developed countries found wide variations in survival rates, but the stage at diagnosis only partly explained the differences.

The Department of Health’s National Awareness and Early Diagnosis Initiative has highlighted GPs as a crucial area to improve survivial rates.

The researchers found lung cancer patients in the UK had lower survival rates than patients in other developed countries such as Australia and Sweden, partly because they presented at a worse stage, according to an analysis by the Cancer Research UK Cancer Survival Group based at the London School of Hygiene and Tropical Medicine.

But they also found ‘wide disparities’ in stage-specific survival that suggested other factors were important for survival rates.

It found that the age-standardised one-year net survival from non-small cell lung cancer ranged from 30% in the UK to 46% in Sweden.

Lung cancer was generally diagnosed at an advanced stage, and for non-small cell lung cancer, the proportion of patients with metastatic disease at diagnosis was about 48% in the UK and 55% in Denmark.

However, there were also wide international differences in stage-specific survival age-standardised one-year net survival from non-small cell lung cancer. For patients with early stage non-small cell lung cancer, survival rates were 16% lower in the UK patients than for people in Sweden, and for late stage disease survival was 10% lower. Similar patterns were found for small cell lung cancer.

The researchers concluded: ‘Differences in stage at diagnosis explain some of the international variation in lung cancer survival, but wide disparities in stage-specific survival suggest that other factors such as treatment are also important.’

They noted that previous research has shown that lung cancer patients in the UK are less likely to have chemotherapy, radiotherapy and surgery than patients in other developed countries.

Thorax 2013, online 11 Feb