Differences in lung cancer management and survival between the UK and other Countries

It is not well understood why survival of lung cancer patients in the United Kingdom is lower than in other similar European countries. Surgical resection, the only potentially curative treatment of lung cancer, in the UK is performed only in about 8% of cases, a much lower rate than the >20% resectability recorded in most other regions of Europe and of the USA.
The aim of this study is to compare the demography, management and outcome of patients presenting with lung cancer, between two similar areas, one in Northern England, Teesside, and one in Northern Italy, Varese, with a similar incidence of lung cancer, but historically with different resection rates and different 5-year survival rates. Data was collected prospectively on all new cases of lung cancer diagnosed in the year 2000 in the Teesside District and in the Varese District, using an identical database to facilitate comparison of patient demography, diagnosis, management and outcome between the two areas. Overall survival of lung cancer patients was assessed in the year 2004, after 3 years had elapsed since the last patient was enrolled.

The results show that patients with lung cancer in Teesside compared with those in Varese presented at a later stage, with more aggressive types of tumour and had higher co-morbidity. All such features negatively affected the resectability of lung cancer in Teesside, thus providing an explanation for the significantly poorer survival in Teesside (7% at 3 years) compared to Varese (14% at 3 years).

This study suggests that differences in survival do not reflect methodological bias, but a true difference in disease presentation and,
consequently, in its management.
The data of the present study may contribute to understand the differences in lung cancer management and survival between the UK and other Countries.

Bibliographical reference:

Imperatori A et al.: "Lung cancer in Teesside (UK) and Varese (Italy): a comparison of management and survival", Thorax. 2006 Mar;61(3):232-9

Andrea Imperatori, on behalf of all authors

Centro di Ricerca in Chirurgia Toracica, Università dell'Insubria, Varese, Italy