Study: Disparities Seen in Lung Cancer Care, Outcomes Between United States and England

Researchers compared lung cancer care and outcomes, including patient characteristics, stage of cancer at diagnosis, treatment, and overall survival of patients in the United States and England.

Despite advances in lung cancer treatment in recent years, the disease remains the leading cause of cancer deaths in the United States. In a new study, a team of researchers found patients with lung cancer had superior outcomes in the United States compared with patients in England.

In the study, published in the Journal of Thoracic Oncology, researchers analyzed data on more than 170,000 older patients diagnosed with non-small cell lung cancer (NSCLC) in England and the United States between 2008 and 2012.

Using the data, the researchers compared several aspects of lung cancer care and outcomes, including patient characteristics, stage of cancer at diagnosis, treatment, and overall survival.

In the United States, 25% of patients were diagnosed at the earliest stage of cancer compared with 15% of patients in England. Forty-five percent of US patients were diagnosed at stage 4, versus 52% of English patients, according to the study.

Additionally, 60% of US patients diagnosed at stage 1 had surgical treatment compared with only 55% of stage 1 patients in England.

Patients in England had overall poorer survival rates, which is likely attributed to the differences in diagnosis and treatment, according to the study. Two years after diagnosis, 31% of US lung cancer patients were still alive versus only 19% of patients in England, the study reported.

According to the researchers, the findings indicate that patients with lung cancer receive more active treatments and have better survival in the United States compared with England, and that further work needs to be done to improve care overall.

“This should be a call to action in both countries to learn how we could improve care and learn from each other’s systems,” Cary Gross, MD, lead author, professor of medicine and epidemiology at Yale University, said in a press release about the study. “We need to share ideas and best practices, so we can continue to reduce tobacco use, implement effective lung cancer screenings programs, and ensure access to high-quality care.”

References

Andreano A, Peake MD, Janes SM, et al. The care and outcomes of older persons with lung cancer in England and the United States, 2008-2012. Journal of Thoracic Oncology. 2018. https://doi.org/10.1016/j.jtho.2018.04.022