Individual Abstract within a Delegate Designed Symposium Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Clinical practice indicators for Queenslanders with NSCLC: How do we compare? (#144)

Jasotha Sanmugarajah 1 2 3 , Bryan A Chan 2 3 4 , Margot Lehman 2 5 6 , Alison Bolton 2 , Morgan Windsor 2 7 , Danica Cossio 8 , Nathan Dunn 8 , Tracey Guan 8 , Artika Nath 8 , Danny Youlden 8
  1. Gold Coast University Hospital, Gold Coast, Queensland, Australia
  2. Queensland Cancer Control Safety and Quality Partnership, Lung Cancer Subcommittee, Queensland Health, Brisbane, Queensland, Australia
  3. School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
  4. Sunshine Coast University Hospital, Birtinya, Queensland, Australia
  5. Princess Alexandra Hospital, Brisbane, Queensland, Australia
  6. School of Medicine, University of Queensland, Brisbane, Queensland, Australia
  7. The Prince Charles Hospital, Brisbane, Queensland, Australia
  8. Cancer Alliance Queensland, Brisbane, Queensland, Australia

Aims: Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related mortality in Queensland. Our aim was to examine quality indicators for NSCLC in Queensland to assess performance across 28 elements from diagnosis, access, treatment and outcomes. 

Methods: De-identified unit record data were sourced from the population-based Queensland Oncology Repository, which contains linked data from multiple sources. Eligible people were diagnosed with NSCLC between 2012-2021, with follow-up on treatment and mortality available to 31 December 2022. Each quality indicator, changes between 2012-2016 to 2017-2021 were assessed by fitting a multiple Poisson regression model, adjusted for key demographic and clinical covariates.  

Results: Records were included for a total of 20,449 individuals. Significant improvements over the study period were observed for several indicators, including: review by a multidisciplinary team (56% in 2012-2016 compared to 62% in 2017-2021; p<0.001); receipt of any cancer treatment (74% to 79%; p<0.0001); radiation therapy for inoperable early-stage NSCLC (76% to 81%; p=0.02); concurrent chemo-radiotherapy for stage III disease (41% to 53%; p<0.001); and intravenous systemic therapy (IVST) for metastatic NSCLC (44% to 50%; p<0.001). Two-year survival from the time of surgery improved from 85% to 90% (p<0.001). In contrast, there was a decrease in people from rural/remote areas receiving their first treatment within 30 days of diagnosis (48% to 44%; p=0.01). People treated at private facilities had a median wait time to first treatment of 22 days (IQR 11-39), compared with people treated at public facilities, 39 days (IQR 23-57) and 22% of people who received intravenous systemic therapy for NSCLC died within 30 days of their last treatment. 

Conclusion: Ongoing monitoring of quality indicators offers essential benchmarking to identify variation in practice and improvements in care, providing important information for clinicians and Queenslanders with lived experience of lung cancer, to drive consistent, evidence-based care.