NL Journal of Medical and Pharmaceutical Sciences
(ISSN: 3108-0502)

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Lung Cancer Care and Outcomes in the West of Scotland During the Introduction of Managed Clinical Networks

Author(s) : Naeima Houssein*.
DOI : 10.71168/NMP.02.02.128

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Abstract

Aim: This study aimed to evaluate lung cancer treatment patterns and survival outcomes during the early implementation of managed clinical networks in the West of Scotland. Background: The Managed Clinical Networks (MCNs) for lung cancer care in Scotland have been committed to providing and improving services for over 2,000 lung cancer patients annually across the region. Methods: A retrospective cohort study was conducted using secondary data on lung cancer patients registered in the Scottish Cancer Registry between 1997 and 2007, linked with morbidity and service data from the West of Scotland Managed Clinical Network for Lung Cancer (2004–2007). Survival outcomes were assessed with follow-up to June 2009. This time frame captures the early implementation of managed clinical networks and multidisciplinary team-based lung cancer care in Scotland. Results: A total of 19,844 non-MCN patients (1997–2004) and 3,394 MCN patients (2004–2007) were included in the comparative analysis. The sex distribution was nearly identical, with males representing approximately 55% in both. The mean age at diagnosis was slightly lower among MCN patients (69.6 years) compared to non-MCN patients (70.2 years), a significant shift was observed in age distribution across the two cohorts (p = 0.001). The distribution of socioeconomic status, measured by deprivation categories, showed no significant difference between the two groups (p = 0.66). Staging data was missing for 78.3% of the non-MCN patients, and 76. 9% of the MCN patients. Available Staging data revealed notable differences. Fewer MCN patients were diagnosed at stage IV (46.0%) compared to non-MCN patients (55.0%), Treatment modalities showed statistically significant differences. Surgical intervention was more common in the MCN group (11.4%) compared to the non-MCN group (9.3%, p < 0.001). Chemotherapy uptake increased significantly from 21.6% in the non-MCN period to 31.3% during the MCN period (p < 0.001). Radiotherapy use also increased in the MCN group (36.4%) compared to the non-MCN group (30.5%, p < 0.001). 1-year overall survival was better for patients who were in MCN as compared to those who were not in the MCN (27 % vs. 24%). Conclusion: Despite reflecting an earlier era of lung cancer care, these data provide baseline evidence from the initial implementation of networked services, enabling meaningful comparison with contemporary studies. Overall, the findings support the effectiveness of MCNs in improving the quality of lung cancer management in Scotland, particularly in terms of treatment delivery. However, the comparison between pre- and post-MCN cohorts involves distinct calendar periods and therefore observed outcome improvements may be influenced by broader temporal advancements in diagnostic and treatment modalities rather than the MCN effect alone. The quality of lung cancer data needs to be improved for better survival estimates. Keywords: Lung Cancer, Managed Clinical Networks (MCN), Survival Outcomes, Treatment Uptake.

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