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Te Aho O Te Kahu Releases Lung Cancer Quality Improvement Monitoring Report

The Lung Cancer Quality Improvement Monitoring Report released today by Te Aho o Te Kahu, the Cancer Control Agency, aims to provide information to help District Health Boards deliver consistent, high-quality cancer care.

Lung cancer is the leading cause of cancer death in Aotearoa, New Zealand. It is also a disease which contributes to inequities within the health system, with mortality rates three to four times higher for Māori than non-Māori.

The purpose of the report is to analyse data from District Health Boards (DHBs) against eight quality performance indicators (QPIs) to identify disparities in care and variation in outcomes.

“Lung cancer is a deadly disease in New Zealand, with 1,800 Kiwis dying of lung cancer each year,” Te Aho o Te Kahu chief executive Professor Diana Sarfati says.

“We expect the results of the QPI report to drive improvements and reduce inequities for people diagnosed with lung cancer.”

Understanding variation in care is an important first step in improving outcomes for people. This involves comparing both warranted and unwarranted variation between DHBs.

“There could be a range of reasons why there is a variation in data,” Sarfati says.

“Working with the DHBs to understand what is happening on the ground will help to identify unwanted outcomes and address the post-code lottery we know exists in cancer care and diagnostics.”

Māori experience a disproportionate and inequitable burden from lung cancer in Aotearoa. Three of the QPIs – routes to diagnosis, surgical resection and overall survival – showed poorer outcomes for Māori than the rest of the population.

Māori have the lowest overall survival of all ethnic groups, with 37% of people alive one year after diagnosis compared to 40.9% of NZ European people alive one year after diagnosis.

“Making sure there are more equitable outcomes for Māori must remain a priority for all DHBs. The whole health system needs to work together to lessen the burden on Māori.”

A key area of improvement is ensuring earlier diagnosis. Almost half (45%) of lung cancer diagnoses occur following an emergency department presentation.

This is higher than other OEDC countries.

“We know that people who are diagnosed following an ED presentation often have advanced disease. If more people – particularly Māori and Pacific peoples – can be diagnosed earlier, it will lead to better outcomes.”

Despite the higher rate of emergency department diagnosis, the one-year survival rate is higher in New Zealand (41.6%) when compared to the United Kingdom (37.7), but lower than Australia (54.3).

Surgical resection is an important cure for those diagnosed with non-small cell lung cancer. The report shows there is a wide variation in the rate of curative resection across DHBs that will require further investigation.

Te Aho o Te Kahu are planning a quality improvement forum in 2021 to support DHBs to improve performance in lung cancer treatment by sharing improvement initiatives.

The Agency - along with the Health Research Council of New Zealand and the Ministry of Health – also recently announced its intention to fund high quality research into lung cancer screening and lung cancer.

The $6.2 million in funding will provide research which can be used to improve the lives of lung cancer patients and is in line with the priorities outlined in the State of Cancer Report 2020.

Background:

To ensure that New Zealand has a system that delivers consistent, quality cancer care, provided in a way that allows all patients to experience equitable outcomes, Te Aho o Te Kahu, Cancer Control Agency is developing quality performance indicators (QPIs) for different cancers.

QPIs are selected by an expert cancer working group with consumer representation and a range of clinical experts involved in providing patient care. They drive quality care by allowing unwanted variation in care to be identified and facilitate the development of targeted improvement programmes to improve outcomes for people with cancer in New Zealand.

In February 2019, the Bowel Cancer Quality Improvement Report was published. The Lung Cancer Quality Improvement Report is the second report for a specific cancer.

Progress has been made on the development of QPIs for prostate cancer, neuroendocrine tumours, head and neck and pancreatic cancer.

For more information:

Teaho.media@teaho.govt.nz

For soft copy of the report: https://teaho.govt.nz/reports/publications

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