BACKGROUND: Quality indicators for non-small cell lung cancer (NSCLC) have been implemented in Queensland, Australia, to assess performance across 28 elements relating to diagnosis, access, treatment, and outcomes. METHODS: Linked data were sourced from the population-based Queensland Oncology Repository. Eligible people were diagnosed with NSCLC between 2012 and 2021, with follow-up on treatment and mortality available to 31 December 2022. For each indicator, changes between 2012-2016 and 2017-2021 were assessed by fitting a multivariable Poisson regression model. Results from the models were expressed in terms of the relative likelihood (RL) using 2012-2016 as the reference period. RESULTS: Records were included for a total of 20 449 individuals. Significant improvements over the study period were observed for several indicators, including: review by a multidisciplinary team (RL = 1.05, 95% CI 1.03-1.07)
any anticancer treatment received (RL = 1.04, 95% CI 1.03-1.06)
radiation therapy for inoperable early-stage NSCLC (RL = 1.06, 95% CI 1.01-1.11)
concurrent chemo-radiotherapy for stage III disease (RL = 1.35, 95% CI 1.24-1.47)
and intravenous systemic therapy (IVST) for metastatic NSCLC (RL = 1.18, 95% CI 1.13-1.22). Two-year survival from the time of surgery increased from 85% to 90% (p <
0.001). In contrast, fewer people had their performance status documented following MDT review during the latter period (RL = 0.95, 95% CI 0.94-0.96), and there was a decrease in people from rural/remote areas who received their first treatment within 30 days of diagnosis (RL = 0.89, 95% CI 0.81-0.97). CONCLUSIONS: The endorsed suite of quality indicators offers essential benchmarking to enable ongoing monitoring of and improvement in the quality of lung cancer care in Queensland.