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Lung cancer: the importance of seeing a respiratory physician

¹ Western General Hospital, Lothian University Hospitals NHS Trust and ² Scottish Cancer Intelligence Unit, ISD Edinburgh and ³ Trent Cancer Registry, Weston Park Hospital, Sheffield, ⁴ Tayside University Hospitals Trust, Perth Royal Infirmary, Perth and ⁵ Stobhill Hospital, and North Glasgow University Hospitals NHS Trust, Glasgow, UK

CORRESPONDENCE: R Fergusson, Western General Hospital, Lothian University Hospitals NHS Trust Edinburgh, EH4 2XU, UK. Fax: 44 1313433989. E-mail: ron.fergusson@luht.scot.nhs.uk

Keywords: lung cancer, respiratory physician, survival, treatment

Received: July 9, 2002
Accepted July 11, 2002

The Scottish Cancer Therapy Network is funded by grants from the Clinical Resource and Audit Group (CRAG) and the Chief Scientist Office (CSO), both of the Scottish Executive Health Department.

Patients with lung cancer present to and are managed by a variety of clinicians. In this study the effect of involvement by a respiratory physician on the diagnosis, staging, treatment and survival of a large unselected group of lung cancer patients was investigated

The study population was derived from the Scottish Cancer Registry. A total of 3,855 patients diagnosed during 1995 with lung cancer were studied. The data were validated and supplemented by references to medical records.

The study found that a respiratory physician had been involved in the initial management of 2,901 (75.3%) patients. These patients were found more likely to have had the cancer diagnosis confirmed by histological methods and to have received active treatment with surgery, radiotherapy or chemotherapy. Survival, 1 yr after diagnosis was higher in patients who saw a respiratory physician (24.4 versus 11.1%) and benefit was found to have remained 3 yrs after diagnosis (8.1 versus 3.7%). Although the patients who had not seen a respiratory physician were generally older, and had more extensive disease, after correcting for age, stage and other prognostic factors, the relative hazard ratio of death for those not managed by a respiratory physician was 1.44.

The data from this study supports the recommendations of recent lung cancer guidelines for the early involvement by a respiratory physician.

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