About this release

This release by Public Health Scotland (PHS) summarises recent national performance, measured using the national Quality Performance Indicators (QPIs) relating to the diagnosis and treatment of lung cancer. The aim of the indicators is to ensure that efforts to improve treatment are focussed on improving survival and individual care experience whilst reducing variation and supporting the most effective and efficient delivery of care. The indicators for all the included cancers were developed by, and periodically undergo formal review by, Healthcare Improvement Scotland (HIS), PHS and the three regional cancer networks (NCA - North Cancer Alliance; SCAN - South East Scotland Cancer Network; and WoSCAN - West of Scotland Cancer Network). Data is gathered and recorded in a central database (eCASE electronic Cancer Audit Support Environment) by specialised cancer audit teams working in NHS Boards.

This dataset includes patients who were diagnosed with lung cancer (see full list of included anatomical sites in the PHS data definitions document) between January 2022 and December 2024.

Main points

The numbers of patients included in these cancer audit records were:

• 4,671 patients diagnosed in 2024
• 4,905 patients diagnosed in 2023
• 4,897 patients diagnosed in 2022

Lung cancer QPI Performance

See results in the spreadsheet accompanying this publication.

• At Scotland level for 2024, 19 of the 25 QPI targets were met.
• Some of the QPI targets have proved challenging to achieve over the three years (QPIs relating to PET CT, nodal staging, chemoradiotherapy in limited stage small cell lung cancer (SCLC), brain imaging and two metrics on pre-treatment diagnosis).
• Regional cancer networks reported that performance on QPI 4 PET CT was a function of the "overwhelming lack of PET CT capacity", a nationally commissioned resource. Despite this it is however encouraging to see an improvement over the years from 14.3% in 2022 to 32.4% in 2024.
• The NCA report stated that QPI 5 nodal staging was "impacted by patient fitness and comorbidities", with "Multi-Disciplinary Teams agreeing in many such cases that PET (a less invasive approach) was sufficient on its own".
• Regional reports gave differing comments on the poor performance on QPI 15 on pre-treatment diagnosis. There were actions to review processes and decision making, to understand the reasons and identify ways to improve performance against this indicator.
• Regarding QPI 16 on brain imaging, discussion at the National Lung Cancer Audit & Education Event in May 2024 led to a desire to have an overall ‘national’ MDT approach to facilitate the recording of all QPI requirements, including prompts for brain imaging for patients with N2 disease who are being considered for curative treatment.
• QPI 7 Lymph Node Assessment and QPIs 13(i) and (ii), 30- and 90-day mortality - surgery, are not shown as the data is at hospital level. The targets were met nationally throughout.
• Overall, the results based on these QPIs demonstrate a high standard of care is being provided for lung cancer patients in Scotland.

Background

The QPIs were put in place to support quality improvement in the treatment of a range of cancers - see About the QPIs. Scottish territorial health boards are required to report their performance against these nationally agreed indicators under the national cancer quality programme - see Scottish Government letter CEL 06 2012. Reporting in this current format was first undertaken in 2012. Performance for other cancers can be found in QPI reports.

Each of the networks release reports in respect of QPI performance in their region for recent years: NCA, SCAN and WoSCAN. In addition, those directly involved in service improvement can access more detailed information through the Cancer QPI Dashboard within SCRIS (Scottish Cancer Registry and Intelligence Service). Due to the level of detail, access is strictly controlled. New users may apply for authorisation via https://useraccess.nhsnss.scot.nhs.uk.

Further information

As QPI publications cover a three-year period, this publication's next release is February 2029.