Analysis of multidisciplinary lung cancer practice.
BACKGROUND
The aim of this study was to describe the activity of a lung cancer multidisciplinary clinic (MDC) and examine whether this model of clinical practice results in adherence to best-practice guidelines.


METHODS
Prospective analysis of demographic and clinical data in 431 patients referred to a lung cancer MDC for the management of known or suspected thoracic malignancy. Adherence was documented to clinically relevant guideline recommendations concerning timely and evidence-based lung cancer management.


RESULTS
Of 431 patients, 257 were diagnosed with primary lung cancer, mean age 68 years, 70% men and 90% current smokers or ex-smokers. Only 21% were referred with known malignancy and 28% were asymptomatic. Overall, 51% had stages I and II non-small-cell lung cancer, with this bias towards early-stage disease greatest in patients from rural areas. Histological confirmation of lung cancer was obtained in 92%. There was a high rate of adherence to international guideline recommendations concerning timely lung cancer diagnosis, staging and treatment implementation. Similarly, there was adherence to selected key evidence based recommendations for lung cancer management contained in national guidelines.


CONCLUSIONS
Within a MDC, patients receive timely diagnosis, staging and treatment according to evidence-based guideline recommendations. The high proportion of patients receiving active treatment has implications for resource allocation. There is a referral bias towards patients with early non-small-cell lung cancer, particularly in rural patients, suggesting that further education about advances in metastatic lung cancer management is required. This study would support the establishment of regional lung cancer services with links to fully resourced MDC.
Conron
M
M
Department of Respiratory Medicine, St Vincent's Hospital, Melbourne, Victoria, Australia. conronm@svhm.org.au
Phuah
S
S
Steinfort
D
D
Dabscheck
E
E
Wright
G
G
Hart
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D019090:Case Management / Q000458:organization & administration / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D019317:Evidence-Based Medicine; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D033183:Interdisciplinary Communication; D007400:Interprofessional Relations; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D010166:Palliative Care; D010348:Patient Care Team; D010997:Pleural Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011013:Pneumonectomy; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012017:Referral and Consultation; D013899:Thoracic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D014739:Victoria / Q000453:epidemiology
D000970:Antineoplastic Agents