P2.07-008 Victorian Comprehensive Cancer Centre Lung Cancer Clinical Audit: Collecting the UK National Lung Cancer Audit data from hospitals in Australia: Topic: Research, Audits

Clinical audit may improve best practice within health. The UK National Lung Cancer Audit (NLCA) collects data from UK hospitals about care of patients with thoracic cancers. We aimed to replicate collection of the NLCA data elements from hospitals caring for patients with thoracic cancers within the Victorian Comprehensive Cancer Centre (VCCC) and associated Western and Central Melbourne Integrated Cancer Service (WCMICS). Retrospective audit of patients newly-diagnosed with lung cancer or mesothelioma in 2013 at 6 major VCCC or WCMICS hospitals. The objectives were: to adopt/adapt the NLCA dataset for use in the Australian context; and analyze the findings using descriptive statistics to identify variations in care. Individual data items from the NLCA were tailored to the Australian context in consultation with an expert steering committee. Data was collected from existing datasets including the Victorian Cancer Registry, Victorian Admitted Episodes Dataset and individual hospital databases. Individual medical records were audited to collect missing data. 845 patients were diagnosed during 2013. Most were aged 65-80 (55%) and 62% were male. Most had non-small cell lung cancer (81%) with 9% small cell and 2% mesothelioma. Data completeness varied greatly between fields. Headline indicators of clinical care in the table below are compared to NLCA data. A significant area of concern identified was lack of access of many patients to a specialist lung cancer nurse.Tabled 1BenchmarkVCCC/WCMICS (%)NLCA-2013 (%)Patients with histological diagnosis810/845 (96%)(75%)Patients with CT before bronchoscopy384/492 (78%)(91%)NSCLC patients receiving PET scan544/748 (73%)(35%)Patients with stage documented518/845 (61%)(93%)Patients discussed at multi-disciplinary meeting585/845 (69%)(96%)Patients seen by lung cancer nurse specialist110/845 (13%)(84%)Lung cancer nurse specialist present at diagnosis0/845 (0%)(65%)Patients receiving active treatment643/845 (76%)(60%)Patients treated with surgery242/845 (29%)(15%)Patients treated with radiotherapy370/669 (55%)(29%)Patients treated with chemotherapy327/638 (51%)(70%)Patients seen by specialist palliative care179/845 (21%)(30%) Open table in a new tab Lung cancer care at participating hospitals appeared to be comparable or better to many of the headline indicators of the NLCA. However, performing the audit retrospectively resulted in significant amounts of missing data for some fields. For future audits, prospective data collection should be harmonized across sites and correlated with survival outcomes. Initiatives to improve access to specialist lung cancer nurses are urgently needed.