Setting the Benchmark: Patterns of Care and Outcomes for Early-stage Non-small Cell Lung Cancer in Queensland, Australia, 2011-2017

Bryan A Chan; Danny R Youlden; Tracey Guan; Margot Lehman; Morgan Windsor; Alison Bolton; Nathan Dunn; Danica Cossio; Shoni Philpot; Jasotha Sanmugarajah

doi:10.1111/ajco.14177

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Setting the Benchmark: Patterns of Care and Outcomes for Early-stage Non-small Cell Lung Cancer in Queensland, Australia, 2011-2017

Journal article

Open access

Peer reviewed

Setting the Benchmark: Patterns of Care and Outcomes for Early-stage Non-small Cell Lung Cancer in Queensland, Australia, 2011-2017

Bryan A Chan, Danny R Youlden, Tracey Guan, Margot Lehman, Morgan Windsor, Alison Bolton, Nathan Dunn, Danica Cossio, Shoni Philpot and Jasotha Sanmugarajah

Asia-Pacific Journal of Clinical Oncology, Vol.21(6), pp.597-606

2025

DOI: https://doi.org/10.1111/ajco.14177

PMCID: PMC12582347

PMID: 40308036

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Abstract

patterns of care

benchmarking

linked data

treatment outcome

non‐small cell lung cancer

Aim Treatment paradigms for early-stage non-small cell lung cancer (NSCLC) are evolving rapidly. Our aim was to document baseline patterns of care and outcomes at the population level immediately prior to the introduction of immunotherapy. Methods Data were obtained from the Queensland Oncology Repository. The study cohort comprised Queensland residents diagnosed with a non-metastatic primary NSCLC between 2011 and 2017, with follow-up on treatment and mortality to December 31, 2022. Poisson regression was used to determine patient and clinical characteristics associated with receiving different treatment modalities within 1 year of diagnosis. Variations in 5-year observed survival were assessed using flexible parametric modelling. Results A total of 4445 people were included, of whom 30% were treated with surgery only, 15% with surgery plus chemotherapy and/or radiotherapy and 44% with chemotherapy and/or radiotherapy only. The remaining 10% did not receive any recorded treatment. People in outer regional/remote areas had lower rates of radiotherapy (relative likelihood [RL] = 0.87, 95% confidence interval [CI] 0.78–0.97) and chemotherapy (RL = 0.89, 95% CI 0.81–0.98) than those in major cities, but there were no significant differences by First Nations status or socio-economic status. Five-year observed survival varied from 63% (95% CI 60%–65%) for stage I to 41% (38%–45%) for stage II and 20% (18%–22%) for stage III. The treatment modality significantly affected survival irrespective of stage at diagnosis (all p < 0.001). Conclusion Monitoring treatment outcomes for early-stage NSCLC at the population level is crucial for optimizing patient care, resource allocation and informing consumer choice. Emerging approaches involving immunotherapy are expected to further improve outcomes.

Details

Title: Setting the Benchmark: Patterns of Care and Outcomes for Early-stage Non-small Cell Lung Cancer in Queensland, Australia, 2011-2017
Authors: Bryan A Chan (Corresponding Author) - University of the Sunshine Coast, Queensland, Centre for Bioinnovation
Danny R Youlden - Metro South Health
Tracey Guan - Metro South Health
Margot Lehman - Princess Alexandra Hospital
Morgan Windsor - Queensland Health
Alison Bolton - Queensland Health
Nathan Dunn - Metro South Health
Danica Cossio - Metro South Health
Shoni Philpot - Queensland Health
Jasotha Sanmugarajah - Griffith University
Publication details: Asia-Pacific Journal of Clinical Oncology, Vol.21(6), pp.597-606
Publisher: Wiley-Blackwell Publishing Ltd.
Date published: 2025
DOI: 10.1111/ajco.14177
ISSN: 1743-7563
PMID: 40308036; PMC12582347
Copyright note: © 2025 The Author(s). Asia-Pacific Journal of Clinical Oncology published by John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Data Availability: The unit record data used in this study are not publicly available to protect patient privacy and confidentiality. Deidentified data may be available from the corresponding author upon reasonable request.
Grant note: This work was supported by Astrazeneca Australia, biostatistician D.R.Y. was funded by an unrestricted institutional educational grant.
Organisation Unit: Centre for Bioinnovation
Language: English
Record Identifier: 991127097402621
Output Type: Journal article

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Collaboration types: Domestic collaboration
Web Of Science research areas: Oncology

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