Patient outcome and factors influencing lack of histology in patients with clinical diagnosis of lung cancer

Abstract

Introduction

The Department of Health recommends 75% of patients diagnosed with lung cancer should have histology confirmed(1). We review patients in our area with clinical diagnosis to determine factors influencing lack of tissue diagnosis and outcome

Methods

Data review of patients diagnosed with lung cancer 1/1-31/12/2010. Somerset cancer registry was data source. We assess factors leading to lack of tissue diagnosis, treatment offered and patient survival time.

Results

122 patients were diagnosed with lung cancer in 2010. 38(31%) had no histological diagnosis. 17(45%) were male. 26(68%) were aged over 75. 35(92%) had CT chest. 3 didn't: 1 was investigated out of area(OOA), 1 refused and 1 was unfit

Of the 18 unfit for investigation, 10(56%) survived <1/12, 8(44%) survived 1-3/12. 4 of 5 patients who had curative treatment were alive at time of audit.

Conclusion

The DoH target for histological diagnosis wasn't met in our area but there were justifiable reasons for this in the majority. Viewing patients holistically must take precedence. Poor PS predicts poor outcome and hence reasons for focusing on supportive care not aggressive investigation.

Reference

1. National Lung Cancer Audit Report for the audit period 2010. 2011www.ic.nhs.uk/webfiles/Services/NCASP/audits%20and%20reports/NHS_IC_Lung_Cancer_AUDIT_2011_Interactive_PDF_V1.0.pdf.