National Mesothelioma Audit 2020
What We Fund
“The improvements across the board in service performance and patient outcomes are significant and it’s particularly encouraging to see the increased survival rates for both malignant pleural and peritoneal mesothelioma patients."
Liz Darlison, Head of Services for Mesothelioma UK
The fourth report of the National Mesothelioma Audit in the UK was published on 28th May 2020. This is the work of the Royal College of Physicians (RCP), commissioned and funded by Mesothelioma UK.
The National Mesothelioma Audit (NMA) report uses data provided by Public Health England (PHE), the Welsh Cancer Network, the Northern Ireland Cancer Registry (NICR), lung cancer teams in Guernsey and the national peritoneal mesothelioma multidisciplinary team (MDT) at Basingstoke to provide a summary of key findings, national averages and geographical variance across an agreed list of mesothelioma service performance indicators and patient outcomes.
The audit makes nine specific recommendations around quality improvement for the attention of healthcare executives, MDTs and commissioners of mesothelioma services, highlighting where practice deviates from British Thoracic Society (BTS) guidelines.
Key findings are reported as follows:
- There were 7,210 new cases of mesothelioma (6,950 with malignant pleural mesothelioma (MPM) and 260 with peritoneal mesothelioma (PM)) diagnosed between 1 January 2016 and 31 December 2018.
- Data completeness for MPM has improved since the previous audit (2014–16)1 for performance status (PS) (increased to 81% from 69%), stage (increased to 65% from 54%) and clinical nurse specialist (CNS) data completeness (increased to 78% from 67%), and data completeness for all measures were improved for PM. This is due to improvements in data completeness for England with data completeness for Wales remaining excellent.
- Diagnostic and support measures have improved since the previous audit: the proportion of MPM mesothelioma patients discussed by a multidisciplinary team (MDT) has increased (89% from 81%), CNS assessment has increased (70% from 54%), and the proportion of pathologically diagnosed cases with non-specific histologic subtyping has reduced (31% from 36%). The proportion of English PM patients referred to the national peritoneal MDT has doubled (28% from 14%).
- Use of systemic anticancer therapy (SACT) and radical debulking surgery for MPM remains stable at 40% and 5% respectively. There is a reduction in use of radiotherapy to 15% (from 22%). Use of SACT for PM has increased to 44% (from 41%).
- Long-term 3-year overall survival is increased for both MPM (10% from 7%) and PM (18% from 15%) compared with the previous audit report.