ArticleThorax2018
Geographical variations in the use of cancer treatments are associated with survival of lung cancer patients.
Article in Thorax, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Survival after radiofrequency ablation and/or chemotherapy for lung cancer and pulmonary metastases: a systematic review and meta-analysis.Frontiers in immunology · 2023Pooled it
- Modelled impact of a multi-cancer early detection screening programme on cancer treatment in England.British journal of cancer · 2026Article
- The early impact of the COVID-19 pandemic on access to colorectal cancer treatment in Brazil: a spatial and interrupted time-series analysis.Lancet regional health. Americas · 2026Article
- Transforming post pandemic cancer services.British journal of cancer · 2024Review
- Utilisation of radiotherapy in lung cancer: A scoping narrative literature review with a focus on the introduction of evidence-based therapeutic approaches in Europe.Clinical and translational radiation oncology · 2024Article
- Three-year follow-up study reveals improved survival rate in NSCLC patients underwent guideline-concordant diagnosis and treatment.Frontiers in oncology · 2024Article
- Real-World Patterns and Decision Drivers of Radiotherapy for Lung Cancer Patients in Romania: RADIO-NET Study Results.Diagnostics (Basel, Switzerland) · 2022Article
- Optimal and actual rates of Stereotactic Ablative Body Radiotherapy (SABR) utilisation for primary lung cancer in Australia.Clinical and translational radiation oncology · 2022Article
- The promises and challenges of early non-small cell lung cancer detection: patient perceptions, low-dose CT screening, bronchoscopy and biomarkers.Molecular oncology · 2021Review
- Navigating Diagnostic and Treatment Decisions in Non-Small Cell Lung Cancer: Expert Commentary on the Multidisciplinary Team Approach.The oncologist · 2021Review
- Patient experiences of the urgent cancer referral pathway-Can the NHS do better? Semi-structured interviews with patients with upper gastrointestinal cancer.Health expectations : an international journal of public participation in health care and health policy · 2020Article
- Association between use of urgent suspected cancer referral and mortality and stage at diagnosis: a 5-year national cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Predictors of the regional variation of prostatectomy or radiotherapy: evidence from German cancer registries.Journal of cancer research and clinical oncology · 2020Article
- Management of patients with early stage lung cancer - why do some patients not receive treatment with curative intent?BMC cancer · 2020Article
- What is the optimal radiotherapy utilization rate for lung cancer?-a systematic review.Translational lung cancer research · 2019Review
- Understanding Differences in Cancer Survival between Populations: A New Approach and Application to Breast Cancer Survival Differentials between Danish Regions.International journal of environmental research and public health · 2019Article
- Accountability in the NHS: the impact on cancer care.Ecancermedicalscience · 2018Article
- Preoperative Physical Activity Predicts Surgical Outcomes Following Lung Cancer Resection.Integrative cancer therapiesArticle
Corrections and comments
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Authors and funding
12 authors at 8 institutions in 2 countries.
Funding
Abstract
introductionLung cancer outcomes in England are inferior to comparable countries. Patient or disease characteristics, healthcare-seeking behaviour, diagnostic pathways, and oncology service provision may contribute. We aimed to quantify associations between geographic variations in treatment and survival of patients in England.
methodsWe retrieved detailed cancer registration data to analyse the variation in survival of 176,225 lung cancer patients, diagnosed 2010-2014. We used Kaplan-Meier analysis and Cox proportional hazards regression to investigate survival in the two-year period following diagnosis.
resultsSurvival improved over the period studied. The use of active treatment varied between geographical areas, with inter-quintile ranges of 9%-17% for surgical resection, 4%-13% for radical radiotherapy, and 22%-35% for chemotherapy. At 2 years, there were 188 potentially avoidable deaths annually for surgical resection, and 373 for radical radiotherapy, if all treated proportions were the same as in the highest quintiles. At the 6 month time-point, 318 deaths per year could be postponed if chemotherapy use for all patients was as in the highest quintile. The results were robust to statistical adjustments for age, sex, socio-economic status, performance status and co-morbidity.
conclusionThe extent of use of different treatment modalities varies between geographical areas in England. These variations are not attributable to measurable patient and tumour characteristics, and more likely reflect differences in clinical management between local multi-disciplinary teams. The data suggest improvement over time, but there is potential for further survival gains if the use of active treatments in all areas could be increased towards the highest current regional rates.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.