Examining Variation In The Burden Of Lung Cancer Across GP Clusters In Wales

Dyfed HUWS, Health Intelligence, Public Health Wales, United Kingdom
THOMAS R. 1 , LONG T. 1 , WHITE C. 1 , HOWE J. 1 , SLYNE C. 1

1 Welsh Cancer Intelligence and Surveillance Unit

Examining variation in the burden of lung cancer across groups of GP practices developing collaborative working (GP clusters) in Wales.
We extracted data from the Welsh Cancer Intelligence and Surveillance Unit’s Cancer Registry for patients diagnosed with lung cancer between 2009 and 2013 living in Wales and registered with a Welsh GP at diagnosis.  Population figures were obtained from NHS Wales Informatics Service for each GP practice.  The Welsh Index of Multiple Deprivation 2014 was used to assign a deprivation half to lung cancer patients, and also to the population of each GP practice.  We calculated crude incidence rates and one-year relative survival rates for GP clusters by sex, deprivation half and stage.
The highest crude incidence rate in men was two and a half times higher than the lowest (119.2 and 46.9 per 100,000 population respectively).  In women, the highest incidence rate was almost three times higher than the lowest rate (100.9 and 35.3 per 100,000 population respectively).
For relative survival, there was a 29.5 percentage point difference in men and a 25.5 percentage point difference in women between the highest and lowest relative survival.
Crude incidence rates were generally higher in the most deprived half of each GP cluster.  There was no clear relationship between deprivation and survival.
For the majority of GP clusters, most lung cancer patients were diagnosed at a late stage (stages 3 and 4) where relative survival was statistically significantly lower than relative survival from early stage lung cancer (22.5% and 71.2% respectively for Wales).
There was wide variation in incidence and survival between GP clusters when considering sex, deprivation and stage.  There is still work to be done to improve survival across Wales, including increasing the number of lung cancer cases diagnosed at an early and potentially treatable stage.