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Objective: To use linked NSW Cancer Registry and hospital lung cancer (LC) data for raising discussion points on how to improve outcomes. Design: Historical cohort - cases diagnosed in 2003-2007. Setting: New South Wales, Australia. Outcome Measures: Relative odds (OR) of localised disease and resection of non-small cases (NSCLC) using multiple logistic regression. Comparisons of risk of NSCLC death using competing risk regression. Findings: (1) Older patients have fewer resections of localised NSCLC [adjusted OR 95% CLs; 80+Vs (2) Compared with public patients, the health insured: have higher odds of localised LC [adjusted OR, 1.23 (1.12, 1.35] and resection for localised NSCLC [adjusted OR, 2.08 (1.70, 2.54)]; are more likely to have lobectomies than wedge/segmental resections (p (3) Patients born in non-English speaking countries have lower odds of localised disease [adjusted OR, 0.88 (0.79, 0.99)]. - Question: Could this difference be decreased by reducing cultural and language barriers? (4) Cancers of pulmonary lobes rather than the main bronchus pose lower risks of LC death. Question: Could outcomes for main bronchus cancers be improved by up-skilling or referral to higher-volume centres? (5) Greater extent of disease is strongly predictive of case fatality - Question: Could LC deaths be reduced by earlier treatment? (6) Use of lobectomies varies - Question: Could survival be increased through greater use of lobectomies for localised NSCLC? Conclusions: Linked cancer registry and hospital data can increase system-wide understanding of local health-service delivery and prompt discussion points on how to improve outcomes.

Using Linked Lung Cancer Registry and Hospital Data for Guiding Health Service Improvement