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

Quality indicators for non-small cell lung cancer (NSCLC) have been implemented in Queensland, Australia, to assess performance across 28 elements relating to diagnosis, access, treatment, and outcomes.

Linked data were sourced from the population-based Queensland Oncology Repository. Eligible people were diagnosed with NSCLC between 2012 and 2021, with follow-up on treatment and mortality available to 31 December 2022. For each indicator, changes between 2012-2016 and 2017-2021 were assessed by fitting a multivariable Poisson regression model. Results from the models were expressed in terms of the relative likelihood (RL) using 2012-2016 as the reference period.

Records were included for a total of 20 449 individuals. Significant improvements over the study period were observed for several indicators, including: review by a multidisciplinary team (RL = 1.05, 95% CI 1.03-1.07); any anticancer treatment received (RL = 1.04, 95% CI 1.03-1.06); radiation therapy for inoperable early-stage NSCLC (RL = 1.06, 95% CI 1.01-1.11); concurrent chemo-radiotherapy for stage III disease (RL = 1.35, 95% CI 1.24-1.47); and intravenous systemic therapy (IVST) for metastatic NSCLC (RL = 1.18, 95% CI 1.13-1.22). Two-year survival from the time of surgery increased from 85% to 90% (p < 0.001). In contrast, fewer people had their performance status documented following MDT review during the latter period (RL = 0.95, 95% CI 0.94-0.96), and there was a decrease in people from rural/remote areas who received their first treatment within 30 days of diagnosis (RL = 0.89, 95% CI 0.81-0.97).

The endorsed suite of quality indicators offers essential benchmarking to enable ongoing monitoring of and improvement in the quality of lung cancer care in Queensland.