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Lung cancer: diagnosis and management [CG121]

Measuring the use of this guidance

Recommendation: 1.2.1

Find out what the patient knows about their condition without assuming a level of knowledge. Provide patients with the opportunity to discuss tests and treatment options in a private environment, with the support of carers, and time to make an informed choice. [new 2011]

What was measured: Proportion of lung cancer patients who reported being told they could bring a family member or friend with them when they were first told they had cancer.
Data collection end: June 2015
79.9%
Data collection end: June 2016
77.9%
Data collection end: March 2018
76.9%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.


Recommendation: 1.2.2

Ensure that a lung cancer clinical nurse specialist is available at all stages of care to support patients and carers. [new 2011]

What was measured: Proportion of lung cancer patients who reported that they were given the name of a Clinical Nurse Specialist who would support them through their treatment.
Data collection end: June 2015
93.4%
Data collection end: June 2016
93.8%
Data collection end: March 2018
94.1%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.

What was measured: Proportion of lung cancer patients who reported that they found it easy to contact their Clinical Nurse Specialist.
Data collection end: June 2015
88.5%
Data collection end: June 2016
87.6%
Data collection end: March 2018
86.7%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.

What was measured: Seen by lung cancer nurse specialist.
Data collection end: December 2014
77.5%
Data collection end: December 2015
54.8%
Area covered: National
Source: Royal College of Physicians. National lung cancer audit.

What was measured: Assessed by lung cancer nurse specialist (England only).
Data collection end: December 2016
70.3%
Area covered: National
Source: Royal College of Physicians. National lung cancer audit.

What was measured: Lung cancer nurse specialist present at diagnosis (England only).
Data collection end: December 2016
57.8%
Area covered: National
Source: Royal College of Physicians. National lung cancer audit.


Recommendation: 1.2.3

Offer accurate and easy-to-understand information to patients and their carers. Explain the tests and treatment options, including potential survival benefits, side effects and effect on symptoms. [new 2011]

What was measured: Proportion of lung cancer patients who reported that, before their cancer treatment started, their treatment options were explained to them.
Data collection end: June 2015
84.3%
Data collection end: June 2016
83.4%
Data collection end: March 2018
84.3%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.

What was measured: Proportion of lung cancer patients who reported that the possible side effect(s) of treatments were definitely explained to them in a way they could understand.
Data collection end: June 2015
74.3%
Data collection end: June 2016
74%
Data collection end: March 2018
74.6%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.


Recommendation: 1.2.10

Share information between healthcare professionals about: • any problems the patient has • the management plan • what the patient has been told • what the patient has understood (where possible) • the involvement of other agencies • any advance decision made by the patient. [new 2011]

What was measured: Proportion of lung cancer patients who reported that, as far as they know, their GP was given enough information about their condition and the treatment they had at the hospital.
Data collection end: June 2015
94.8%
Data collection end: June 2016
95%
Data collection end: March 2018
94.8%
Area covered: England
Source: Quality Health. National Cancer Patient Experience Survey.


Recommendation: 1.3.13

Chest CT should be performed before: • an intended fibreoptic bronchoscopy • any other biopsy procedure. (2005)

What was measured: CT performed before bronchosopy.
Data collection end: December 2015
91%
Area covered: National
Source: Royal College of Physicians. National lung cancer audit.


Recommendation: 1.3.26

Consider MRI or CT of the head in patients selected for treatment with curative intent, especially in stage III disease. [new 2011]

What was measured: Proportion of hospitals that routinely brain imaged stage IIIa lung cancer patients.
Data collection end: May 2014
83%
Area covered: England
Source: Hudson BJC (2015) Brain imaging in lung cancer patients without symptoms of brain metastases: A national survey of current practice in England. Clinical Radiology.


Recommendation: 1.3.32

The care of all patients with a working diagnosis of lung cancer should be discussed at a lung cancer MDT meeting

What was measured: Patient discussed at MDT (England only).
Data collection end: December 2014
93.6%
Data collection end: December 2015
81.7%
Area covered: National
Source: Royal College of Physicians. National lung cancer audit.

What was measured: Patient discussed at MDT (England only).
Data collection end: December 2016
87.5%
Number that met the criteria: 32157 / 36758
Area covered: National
Source: Royal College of Physicians. National lung cancer audit.


Recommendation: 1.4.3

Offer nicotine replacement therapy and other therapies to help patients to stop smoking in line with Smoking cessation services (NICE public health guidance 10) and Varenicline for smoking cessation (NICE technology appraisal guidance 123). [new 2011]

What was measured: Proportion of providers with access to smoking cessation services.
Data collection end: December 2016
67%
Area covered: National
Source: Royal College of Physicians. National lung cancer audit.


Recommendation: 1.4.40

"Chemotherapy should be offered to patients with stage III or IV NSCLC and good performance status (WHO 0, 1 or a Karnofsky score of 80–100), to improve survival, disease control and quality of life. [2005]"

What was measured: Proportion of patients with stage IIIB/IV, performance status 0-1, NSCLC who had chemotherapy (England only).
Data collection end: December 2016
62.5%
Number that met the criteria: 4214 / 6746
Area covered: National
Source: Royal College of Physicians. National lung cancer audit.


Recommendation: 1.4.41

Chemotherapy for advanced NSCLC should be a combination of a single third-generation drug (docetaxel, gemcitabine, paclitaxel or vinorelbine) plus a platinum drug. Either carboplatin or cisplatin may be administered, taking account of their toxicities, efficacy and convenience. [2005]

What was measured: Proportion of patients with stage IIIB/IV, performance status 0-1, NSCLC who had systemic anticancer treatment, who received gemcitabine and carboplatin (England only).
Data collection end: December 2016
20.6%
Area covered: National
Source: Royal College of Physicians. National lung cancer audit.



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