Factors explaining differences in lung cancer survival by sex and socio-economic disadvantage: A causal mediation analysis using the Victorian Lung Cancer Registry data (2022-current)
This study is a collaboration study with the Victorian Cancer Council (Victorian Cancer Registry and it will use the Victorian Lung Cancer Registry data, including cases with first primary lung cancer diagnosed since 2011, to examine the mediating role of stage at diagnosis, histologic types, smoking, co-morbidities, performance status, receipt and timeliness of definitive treatment, and hospital type (public/private) in inequalities in lung cancer survival by sex and SEP.
Understanding the outcome disparity for Aboriginal and Torres Strait Islander people diagnosed with lung cancer: does disease biology contribute? (2021-current)
This project is working together with the Victorian Cancer Council (Victorian Cancer Registry) and a PhD candidate to understand demographics, disease biology and outcomes for First Nations people, with particular attention to understanding the frequency and impact of oncogenic driver mutations in this vulnerable group. This study will use clinical data collected by the VLCR, including timeliness of first treatment, smoking status and survival.
Development of a benchmarked surgical performance checklist (2021-current).
This research project is being led by A/P Gavin Wright to use clinical and surgical data collected by the Lung Cancer Registry and by ANZTHOR (a clinician led surgical database managed by BioGRID) to analyse pre-operative, intra-operative and post-operative care. This study aims to develop a benchmarked “checklist for best practice surgical care” for health services and clinicians to monitor surgical care and outcomes delivered by their institutions.
Patterns of care of Stage III NSCLC in Victoria (2020-current)
The Lung Cancer Registry provided clinical data and led a data linkage project with CVDL to extract Victorian Radiotherapy Minimum Dataset (VRMDS) to support a PhD study investigating NSCLC Stage III patterns of care. The study found that a third of NSCLC stage III patients diagnosed from 2011-2019 did not receive radical treatment and strategies to facilitate radical treatment and better support decisions making between increasing multimodality options are required.
Building a Value-based Health Care Model for lung cancer (2019-current)
The Lung Cancer Registry has been funded by the MRFF (via Monash Partners Comprehensive Cancer Consortium (MPCCC)), to conduct a pilot study that aims to develop a value-based health (VbHC) model for lung cancer care at selected cancer health services in Victoria. To develop the VbHC model, the Lung Cancer Registry is utilising clinical and administrative data already collected by the Registry, with electronically collected PROs [EORTC QLQ-C30, EORTC LC-29] PREs, HRQoL survey responses and derived costs for health services delivered to patients.
Surveillance, Patterns of Recurrence and Survivorship in Early Stage Lung Cancer Patients- Pilot Study (2019-2020)
This study was conducted to observe the patterns of surveillance of early stage Non-small cell lung cancer (NSCLC) patients and their impact on detection of recurrence/new disease, retreatment and survival. The study included 200 patients from a large tertiary hospital in Melbourne Results demonstrated a significantly increased survival for patients that had a documented follow up protocol and routine imaging detection of an event. Cox regression analysis reported decreased likelihood of death for those surgically treated (HR:0.518, 95%CI:0.33- 0.83), and for those who had subsequent treatment with curative intent (HR:0.15, 95%CI: 0.05-0.46). An increased likelihood of death was reported in patients with no follow up protocol (HR: 2.24, 95% CI: 1.31-3.83) and for patients with recurrent disease (HR: 3.0, 95%CI: 2.34-6.20). Conclusion: Despite the variation in routine surveillance protocols at Alfred Health, patients with a documented follow up protocol were shown to have improved survival. This may be due to the fact that routine imaging detected tumour recurrence or a new primary earlier than otherwise might have been the case. Follow-up research in additional health services is recommended.
Evaluating prognostic factors for sex differences in lung cancer survival: findings from a population-based lung cancer registry in Australia (2022-current)
The Daffodil Centre (a joint venture between University of Sydney and Cancer Council NSW) is working with the VLCR to understand potential drivers of sex-related disparity in lung cancer survival, which currently indicates that Victorian women tend to survive a lung cancer diagnosis longer than Victorian men. The current findings remain largely speculative because of the lack of data on the key prognostic factors including cancer stage at diagnosis, and treatment received and this study will compare survival by sex in VLCR patients diagnosed between 2012 and 2020.
Examining impact of COVID pandemic on lung cancer diagnosis and stage presentation in Victoria (2021-current).
This project is using data collected by Lung Cancer Registry and the Victorian Cancer Registry, linked to administrative data from the DHHS to provide a comparison of diagnostic and management trends for primary lung cancer in 2020 Q2-3 (first peak of COVID cases) with 2018-2019 Q2-3. This analysis will include multiple measures including clinical stage at presentation to determine if there has been stage migration due to delays in diagnosis.
Australian-New Zealand Lung Cancer Registry Protocol (ANZLCR) (2021-curent)
This project is bringing together key stakeholders from Australia and New Zealand to develop a bi-national lung cancer CQR model. The protocol paper includes objectives of the ANZLCR to measure and report benchmarked outcomes reflecting quality of care, describe unwarranted variation in care, provide a data infrastructure for data-driven improvements in lung cancer care and to develop a clinical data repository to support research. The ANZLCR protocol includes the suggestion to re-define a revised set of quality indicators using a DEPLHI process, as well as establish a truly national governance and management structure for a bi-national lung cancer CQR.
Outcomes and survival in lung cancer surgery: A comparison of the Victorian Lung Cancer Registry and the Danish Lung Cancer Registry (2019-2020)
The Lung Cancer Registry worked with Dr Michael Stenger, a visiting cardio-thoracic surgeon from Denmark, to investigate the potential of clinical quality lung cancer registries in Victoria, and Denmark, to benchmark lung cancer surgery clinical outcomes. This study found the resection rate was 26.3% in Victoria and 28% in Denmark, but a higher proportion of Victorian patients underwent sub lobar resection (29.8% vs 11.9%). Stage concordance was 59.6% and 54.9% in Victoria and Denmark, respectively. The 30- and 90-day mortality was 1.3% and 2.6% in Victoria, compared to 1.4% and 2.8% in Denmark with no difference in overall survival (p=0.10) or risk-adjusted survival (HR: 1.07 (95% CI: 0.95-1.20); p=0.27).
Determining patterns of care and access to novel therapies for mesothelioma (2022-current)
This project has been funded by Cancer Council Victoria (via Grants-in-Aid), which aims to assess how patients with mesothelioma are managed, whether they are routinely receiving the latest treatments including immunotherapy, and a detailed understanding of their quality of life.
The study consists of four parts:
1) A mixed method, co-designed project to create a short, bespoke experience of care and quality of
life survey for mesothelioma. This will be a collaboration between the researchers, health professionals in mesothelioma care and people (patients and carers) living with mesothelioma identified through Victorian asbestos and mesothelioma support groups
2) A modified Delphi process involving collaboration between the researchers, health professionals with expertise in mesothelioma care and consumer participants to identify the key clinical quality indicators that reflect optimal, evidence-based (or expert consensus if there’s a lack of level 1 or 2
evidence) care for patients with MM
3) An outcomes registry for patients with mesothelioma based on the Australian Lung Cancer Registry, ALCR (previously the Victorian Lung Cancer Registry)) with incorporation of a bespoke assessment of quality of life, quality of care and links with the AMR asbestos registry which already routinely conducts exposure surveys
4) The creation of a Victorian Integrated Cancer Services (ICS) learning health system model to address gaps in quality of care and improve access to optimal care
Current PhD candidates
- Ms Sanuki Tissera, “Risk adjustment models in lung cancer patients in Victoria”.
- Dr Evangeline Samuel, “Decision support systems in lung cancer”.
Accessing VLCR data
VLCR data is multi-purpose and can be used in clinical planning, quality improvement and research. Access to VLCR data is restricted to ensure that registrant’s privacy is protected.
Researchers or institutions who would like to request aggregate VLCR data will be required to complete the following steps:
- Contact the VLCR Coordinator to discuss your research proposal, the application process and request the data access form.
- Submit a completed data access form, with a HREC Approval Certificate and other relevant documentation for review of the VLCR Steering Committee
- Clinicians contributing data to the registry, can request their own data from the VLCR Coordinator at no charge
- Researchers submitting data for external research purposes may be charged a fee.