Why we need the national lung cancer audit to continue

Understanding what is happening in clinical practice and how this is affecting patient outcomes depends on having first-class data collection and reporting.  Consequently, the UKLCC welcomed the recent news that the Royal College of Physician’s contract for the National Lung Cancer Audit (NLCA) has been extended to October 2021.

Since 2004, when it was established, the NLCA has played an instrumental role in helping the NHS make steady progress in improving the quality of care and outcomes for lung cancer patients. Prior to its introduction, lung cancer care in the UK was fragmented and five-year lung cancer survival in the 1990s averaged around the five percent mark.  The UKLCC was a key protagonist in lobbying NHS Trusts to participate in the Audit – which now represents data from more than 170 individual organisations. 

As a result, the NLCA has continued to provide valuable insights into regional and national service performance and been used to set standards of care – for example, 90% of patients should be assessed by a lung cancer nurse specialist.1 These standards are designed to make the treatment and outcomes  in England reach the levels seen in a number of other countries with  comparable health systems.  They also encourage those organisations with the most divergent results to look closely at them and formulate action plans to improve performance.

However, whilst outcomes have improved over the past decade or so, the latest findings from the NLCA have identified that only just over a third (37%) of lung cancer patients will survive for one-year, which is unchanged from the previous year.1  In addition, the latest figures from the Office for National Statistics revealed that just 14% of men and 19% of women in England will still be alive after five years from diagnosis.2 Although that is a great improvement from the level back in the 1990s, UK lung cancer survival rates still lag behind certain Westernised countries.3 There are also still wide variations in treatment and survival rates between different parts of the UK.1

It is therefore imperative we do not become complacent and whilst we very much welcome news of the recent contract extension, we need to ensure the long-term future of the NLCA so we can continue to drive further improvement in lung cancer care and outcomes of all MDTs – and help to reach the UKLCC’s ambition of doubling five-year survival rates to 25% by 2025.

Despite the current toll of the coronavirus pandemic, we hope that Trusts continue to upload and share their lung cancer data. Lung cancer patients deserve it.   

Professor Mick Peake, Clinical Lead UKLCC Clinical Advisory Group; Clinical Director, Centre for Cancer Outcomes, North Central and East London Cancer Alliance; Emeritus Consultant and Honorary Professor of Respiratory Medicine, University of Leicester; Honorary Clinical Lead, NCRAS; Specialist Clinical Advisor, Cancer Research UK