RT Journal Article
SR Electronic
T1 Lung cancer: the importance of seeing a respiratory physician
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 606
OP 610
DO 10.1183/09031936.03.00060803
VO 21
IS 4
A1 R.J. Fergusson
A1 C.S. Thomson
A1 D.H. Brewster
A1 P.H. Brown
A1 R. Milroy
A1 on behalf of the Scottish Cancer Trials Lung Group and the Scottish Cancer Therapy Network
YR 2003
UL http://erj.ersjournals.com/content/21/4/606.abstract
AB 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. 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.