Mediastinal staging of non-small-cell lung cancer among Australasian thoracic physicians: clinical practice and constraints on minimally invasive techniques
Article first published online: 14 JUN 2012
© 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians
Internal Medicine Journal
Volume 42, Issue 6, pages 627–633, June 2012
How to Cite
Dabscheck, E. J., Steinfort, D. P., Irving, L. B. and Hew, M. (2012), Mediastinal staging of non-small-cell lung cancer among Australasian thoracic physicians: clinical practice and constraints on minimally invasive techniques. Internal Medicine Journal, 42: 627–633. doi: 10.1111/j.1445-5994.2011.02683.x
Conflict of interest: None.
- Issue published online: 14 JUN 2012
- Article first published online: 14 JUN 2012
- Accepted manuscript online: 21 DEC 2011 09:16AM EST
- Received 3 March 2011; accepted 23 March 2011.
- non-small-cell lung carcinoma;
- endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA);
- mediastinal staging;
- access to health services
Background/Aim: We determined current practice among Australasian thoracic physicians in the mediastinal staging of non-small-cell lung cancer (NSCLC). We focused on the availability of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) and constraints to its use, as there has been no systematic analysis regarding the availability and uptake of this new technology among thoracic physicians.
Methods: Physician members of the Thoracic Society of Australia and New Zealand were emailed a survey seeking their current approach to three scenarios requiring mediastinal staging of NSCLC. Respondents were also asked for their preferred investigation for each scenario if any current constraints were removed. Relevant demographic information was sought.
Results: We received 164 responses from 512 Australasian physicians (34%). Without constraints, EBUS-TBNA was the preferred investigation for all three clinical scenarios, but only 33% of respondents had access to EBUS-TBNA. Constraints included lack of availability and lack of expertise. Reduced EBUS-TBNA access was associated with a number of clinician factors.
Conclusions: Australasian thoracic physicians prefer EBUS-TBNA for the mediastinal staging of NSCLC, but access to EBUS-TBNA services is limited. We recommend targeted measures to improve access to EBUS-TBNA use and optimise mediastinal staging of NSCLC.