[State of practice: initial evaluation of lung cancer patients for whom surgery is the first treatment – portrait of the situation in Québec from 2016 to 2019]
Boily G, Abiala G, Guédon AC, Lanthier J
Record ID 32018013151
French
Original Title:
Évaluation initiale de personnes atteintes d’un cancer du poumon et pour qui le premier traitement est la chirurgie – Portrait québécois 2016 - 2019
Authors' results and conclusions:
RESULTS: As regards the use of services, the following main general findings were made (see the
more detailed findings):
• The median and mean numbers of services received per patient during the initial
evaluation were both 7. The number of services received per patient varied from
region to region. There was no correlation between the number of services
received and the time from first evidence of cancer to surgery interval (low
Pearson’s R2).
• The services used most were chest computed tomography (CT), respiratory
testing, bronchoscopy, and PET-CT (positron emission tomography)-CT.
• The services repeated the most often were bronchoscopy (33% of the patients)
and chest CT (+/- abdomen; 32%).
• The sequential service trajectories were very numerous, and no particular one
was observed in a large proportion of the patients.
• The analyses concerning the use of the main services showed wide variation
between the regions.
• Bronchoscopy was performed more often than actually seems appropriate
(opinion of the clinicians who were consulted).
• Greater preference should have been given to nonsurgical procedures
(EBUS/EUS; endobronchial ultrasound/transesophageal echoendoscopy) as the
first approach for invasive mediastinum evaluation over surgical procedures
(mediastinoscopy/mediastinotomy).
• An invasive mediastinum evaluation should have been performed more
systematically in the patients in whom a pneumonectomy was being considered.
• The use of MRI (magnetic resonance imaging) to look for brain metastases
should have been performed more systematically in the patients in whom a
pneumonectomy was being considered. In addition to this portrait of the situation in Québec, a sheet showing the main results
and the highlights has been produced concerning the patients in each of Québec’s health
and social services regions. The results for each region and for all of Québec regarding
12 parameters are presented in a table, and graphs show the region’s standing relative to
the value for all of Québec and to those of the other regions.
Authors' methods:
Clinical administrative data were studied for the purpose of constructing a portrait of the
initial evaluation of lung cancer patients in Québec for whom surgery was the first
treatment. The main parameters examined are the hospitals that managed these
patients, the interval from the first evidence of cancer to surgery, the number of services
received per patient, and the use of services during the initial evaluation (imaging,
examinations and diagnostic procedures). When possible, the results were assessed in
relation to the recommendations in INESSS’s Algorithmes d’investigation, de traitement
et de suivi du cancer du poumon (Lung cancer investigation, treatment and follow-up
algorithms). A cohort of 8239 lung cancer patients first treated with surgery (“surgery” cohort) and in
whom the date of first evidence of cancer was between January 1, 2016 and December
31, 2019 (pre-pandemic period) was created from INESSS’s lung cancer cohort. The
follow-up end date was March 31, 2021. Twenty-seven categories of services were
analyzed. Most of the results are reported for all of Québec and by the patients’ health
and social services region of residence.
Authors' identified further research:
This work is the first portrait of Québec lung cancer practices produced for the purpose of
supporting the efforts of personnel in the health and social services system in their
endeavour to improve the quality of patient care. This portrait can be updated as needed
in order to assess practice changes and the impact of the efforts currently being made in
the system to improve the initial evaluation of lung cancer patients.
Details
Project Status:
Completed
Year Published:
2024
URL for published report:
https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/evaluation-initiale-de-personnes-atteintes-dun-cancer-du-poumon-et-pour-qui-le-premier-traitement-est-la-chirurgie-portrait-quebecois-2016-2019.html
English language abstract:
An English language summary is available
Publication Type:
Other
Country:
Canada
MeSH Terms
- Lung Neoplasms
- Thoracic Surgery
- Disease Management
- Quality of Health Care
Contact
Organisation Name:
Institut national d'excellence en sante et en services sociaux
Contact Address:
L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369
Contact Name:
demande@inesss.qc.ca
Contact Email:
demande@inesss.qc.ca
Copyright:
L'Institut national d'excellence en sante et en services sociaux (INESSS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.