The percentage of lung cancer patients who have a life-saving operation every year in the UK has increased by over 50 per cent in five years, according to the most comprehensive audit ever of the disease.

About one in seven patients – over 4,500 people every year – now has surgery compared to about one in 11 five years ago, according to the National Lung Cancer Audit 2010.

Lung cancer, which kills more people in the UK each year compared to any other form of cancer, is often diagnosed at an advanced stage, which means a substantial proportion - up to three quarters - of patients are not suitable for surgery. However the improved surgery rate suggests that more clinical teams have developed the expertise to assess patients of borderline fitness for surgery and have access to more complex surgical techniques often required in such situations.

The increase mirrors other improvements in key care processes examined by the audit, which this year contains data for almost 100 per cent of cases presenting to secondary care of the estimated 37,600 lung cancer cases in the UK to have been first treated in 2009.

This is thought to be an unprecedented achievement for any audit in the world and is due to the commitment of NHS organisations who submit the data. It is also thought that the audit itself, which began five years ago with data for about 40 per cent of cases for England, has helped drive improvements in care by giving health providers vital information about their performance and how they compare to others.

The audit also shows that the percentage of patients receiving key care measures, such as surgery or anti-cancer treatment like chemotherapy or radiotherapy is improving, but still varies from provider to provider– with interquartile ranges between:

• 9.8 per cent to 16.3 per cent regarding surgery
• 54.0 per cent to 66.5 per cent regarding any active anti-cancer treatment
• 74.2 per cent to 91.5 per cent having a CT scan before undergoing bronchoscopy
• 70.9 per cent to 85.2 per cent regarding diagnosis by tissue biopsy (histological/cytological diagnosis)
• 52.7 per cent to 79.8 per cent of patients with Small Cell Lung Cancer receiving chemotherapy

The variation is only to a limited extent explained by differing complexity of cases from provider to provider. However, the gap between the highest and lowest performing provider is narrowing, as is the gap between the UK and other countries in Western Europe that have historically been rated as having higher quality care.

The audit is managed by The NHS Information Centre in partnership with the Royal College of Physicians and commissioned by the Healthcare Quality Improvement Partnership.

Consultant in Respiratory Medicine Dr Mick Peake, audit clinical lead and clinical lead for NHS Cancer Improvement and the National Cancer Intelligence Network, said:

"It is a tribute to the ongoing work of all the lung cancer specialist teams across the country that we now have such excellent data on the care of lung cancer patients in the UK. We also now have clear evidence that standards of care are improving and we believe that the audit process itself is one of the main factors behind this. Wide variation still exists, however, in the standard or care between different hospitals and we need to continue to strive to bring the care in all units up to the standard of the best.”

From 23 May 2011 the audit report can be accessed at www.ic.nhs.uk/canceraudits/lung

Notes to editors

1. The NHS Information Centre (The NHS IC) is England's authoritative, independent source of health and social care information. It works with a wide range of health and social care providers nationwide to provide the facts and figures that help the NHS and social services run effectively. Its role is to collect data, analyse it and convert it into useful information which helps providers improve their services and supports academics, researchers, regulators and policymakers in their work. The NHS IC also produces more than 120 statistical publications each year across a number of areas including: primary care, health and lifestyles, screening, hospital care, population and geography, social care and workforce and pay statistics. The NHS IC is the largest single provider of clinical audits to the NHS and carries out a range of audits, mainly funded by the Healthcare Quality Improvement Partnership, into cancer, heart disease and diabetes.
2. The Royal College of Physicians (RCP) has been supporting and representing physicians for nearly 500 years. The College sets and monitors standards of medical training to ensure that patients are treated by fully trained and capable doctors, and provides education programmes, lectures, conferences and courses. It also takes a wide role in public health, campaigning for change, advising government and Parliament, and taking part in national debates on medical, clinical and public health issues. It runs a vibrant programme of projects that aim to improve the quality of health care in line with the best evidence for clinical practice: national comparative clinical audit, the measurement of clinical and patient outcomes, clinical change management and guideline development.
3. The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP hosts the contract to manage and develop the National Clinical Audit and Patient Outcomes Programme (NCAPOP). Their purpose is to engage clinicians across England and Wales in systematic evaluation of their clinical practice against standards and to support and encourage improvement in the quality of treatment and care. The programme comprises more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions.
4. In October 2009, the NHS in Wales underwent a major restructuring which resulted in trusts being replaced with health boards. This report is for the calendar year 2009, therefore the decision was made to report using trust codes as most of the data was collected under this structure. Any subsequent reports will use the new health board structure.
5. The interquartile range is the difference in value between the top and bottom quartiles of data records. The bottom quartile contains trusts whose data falls within the lowest 25 per cent of all values; while the top quartile contains trusts with the highest 25 per cent of data values. The middle two quartiles contain the other 50 per cent of trusts.
6. Top and bottom quartiles may contain outlying values at either end of the scale. Trusts with such values should investigate if the data they submitted was affected by quality issues ahead of assessing their level of performance.
7. For media enquiries and interview requests please contact The NHS Information Centre press office on 0845 2576990 or at mediaenquiries@ic.nhs.uk