Quality Indicators for Non-Small Cell Lung Cancer in Queensland, Australia, 2012-2021

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• Quality indicators for non-small cell lung cancer (NSCLC) were implemented in Queensland, Australia.
• These indicators assess 28 elements of care, including diagnosis, access, treatment, and outcomes.

Purpose of the Study:

• To evaluate changes in NSCLC care quality in Queensland between 2012-2016 and 2017-2021.
• To assess the impact of implemented quality indicators on NSCLC patient management and outcomes.

Main Methods:

• Utilized linked data from the Queensland Oncology Repository for 20,449 individuals diagnosed with NSCLC (2012-2021).
• Employed multivariable Poisson regression to analyze changes in 28 quality indicators between two time periods.
• Expressed results as relative likelihood (RL) with 95% confidence intervals (CI).

Main Results:

• Significant improvements observed in multidisciplinary team (MDT) review (RL=1.05), any anticancer treatment (RL=1.04), and specific treatments like radiation therapy for early-stage NSCLC (RL=1.06) and concurrent chemoradiotherapy for stage III disease (RL=1.35).
• Two-year survival post-surgery increased from 85% to 90% (p<0.001).
• Declines noted in performance status documentation post-MDT review (RL=0.95) and timely first treatment for rural/remote patients (RL=0.89).

Conclusions:

• The quality indicators provide essential benchmarking for monitoring and improving lung cancer care in Queensland.
• While overall care quality has improved in several areas, attention is needed to address declines in performance status documentation and rural patient treatment timeliness.