Background

We compared the rates of lung cancer surgery among non-small cell lung cancer (NSCLC) patients across Hospital and Health Service (HHS) areas and demographic groups in Queensland.

Methods

Clinical and surgical data for all Queensland residents diagnosed with non-small cell lung cancer (NSCLC) between 2001 and 2011 were extracted from the Queensland Oncology Repository. Crude rates of lobectomy, partial resection, and pneumonectomy were compared across age and gender. Rates of surgery adjusted for age and sex were compared across Hospital and Health Service (HHS) area, indigenous status, remoteness of residence at diagnosis and socioeconomic group

Results

A total of 14,209 NSCLC patients were identified and included in this study.  2,857 patients (20%) underwent surgery for lung cancer.  Surgical rates were lowest in patients aged 75 and over (14%) and slightly lower in males compared to females (19% vs 22%).  Across eleven HHS areas with more than 100 patients over the study period, adjusted rates ranged from 15% to 23% and were generally lower in remote areas. Two HHS areas experienced adjusted rates (15% and 17%) significantly below the state average. Indigenous patients had lower adjusted rates of surgery compared to non-Indigenous patients (10% vs 20%), notable given the younger age (median 62 yrs vs 69 yrs) of indigenous patients. 

Conclusions

The lower rates of surgery among indigenous lung cancer patients warrant urgent attention given the higher proportion of younger and potentially more operable patients in this subgroup. Regional variation in surgical rates also requires further investigation.