Lung Cancer
Volume 70, Issue 1 , Pages 22-27, October 2010

The trajectory of lung cancer patients in Western Australia—A data linkage study: Still a grim tale

  • Moyez Jiwa

      Affiliations

    • Curtin Health Innovation Research Institute, Curtin University of Technology, GPO Box U1987, Perth, WA 6845, Australia
    • Corresponding Author InformationCorresponding author. Tel.: +61 8 9266 1768; fax: +61 8 9266 2608.
    • ,
  • Eric Maujean

      Affiliations

    • Western Australia Clinical Oncology Group, 46, Ventnor Street, West Perth, WA 6005, Australia
    • ,
  • Katrina Spilsbury

      Affiliations

    • Centre for Population Health Research, School of Public Health, Faculty of Health Sciences, Curtin University of Technology, GPO Box U1987, Perth, WA 6845, Australia
    • ,
  • Tim Threlfal

      Affiliations

    • Western Australian Cancer Registry, PO Box 8172, Perth, WA 6849, Australia

Received 13 May 2009; received in revised form 27 July 2009; accepted 8 January 2010. published online 03 February 2010.

Abstract 

Objective

To plot the trajectory of lung cancer patients by linking multiple data sources in Western Australia.

Design

Database survey, data linkage and postal survey.

Setting

Western Australia.

Participants

Lung cancer patients registered on the cancer registry database of Western Australia, April 2006 to March 2007.

Main outcome measures

Morbidity, mortality, and medical procedures.

Results

950 lung cancer patients were registered on the cancer registry database from April 2006 to March 2007. Sixty five percent were male with a mean age at diagnosis of 70 years (SD 11 years). Approximately 30% were from regional and remote areas of Western Australia. 76% reported a history of smoking, with a mean of 41 pack-years per smoker. One in four cases had metastases at diagnosis. 18% of cases from a tertiary hospital received no active treatment. The median time from the first visit to GP with recognized cancer symptoms until consultation with a specialist was 2 weeks. One in five cases presented directly to the hospital Emergency Department. For 16% of all cases, no symptoms were recorded in the hospital administrative records at the time of presentation. Fifty-two percent of patients had chemotherapy, 49% received radiotherapy and 21% had surgery. 13% of treated patients were readmitted to hospital with complications of therapy. Median survival was 33 weeks (95% CI 30–40).

Conclusion

Data linkage offers limited prospects for exploring the trajectory of patients with lung cancer in Western Australia. The available data indicate that the prognosis of lung cancer remains very poor and that a high proportion of patients are still diagnosed with advanced disease. There is no evidence to suggest that a greater proportion of patients are being offered surgical treatment compared to more than a decade ago. However a greater proportion of cases now receive adjuvant therapies and overall median survival has improved by a matter of weeks.

Keywords: Lung cancer, Data linkage, Prognosis, Surgery, Radiotherapy, Symptoms

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PII: S0169-5002(10)00009-7

doi:10.1016/j.lungcan.2010.01.007

Lung Cancer
Volume 70, Issue 1 , Pages 22-27, October 2010

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