Lung cancer Quality Performance Indicators
Lung cancer quality performance indicators (QPIs) are used to improve the quality of cancer services and deliver better outcomes for people diagnosed with lung cancer.Lung cancer is the leading cause of cancer death in Aotearoa. Lung cancer also contributes to inequities in health outcomes, with mortality rates three to four times higher for Māori compared with non-Māori. The Ministry of Health worked with the National Lung Cancer Working Group (NLCWG) to develop a set of proposed QPIs for lung cancer. This work transferred to Te Aho o Te Kahu in December 2019.
The Ministry of Health’s Cancer Services team, and NLCWG worked together to develop a set of QPIs for lung cancer. The first Lung Cancer Quality Improvement Monitoring Report, using 2015 – 2018 data, was published early 2021. In 2025, the Lung Cancer Quality Improvement Monitoring Report Update, using 2019 – 2022, data was used.
Quality Improvement Monitoring Reports
The original Lung Cancer Quality Improvement Report was published in 2021, covering the years 2015 to 2018. This report presents data for eight QPIs.
In July 2025, the Lung Cancer Quality Improvement Report Update was published. The report update presents data for four QPIs. While all eight QPIs are important for understanding the quality of lung cancer care in New Zealand, we chose to only detail these four in this report because they show either noticeable change over time or, in the case of the QPI regarding lung cancer treatment at the end of life, results that warrant prioritised attention or improvement. The other four indicators showed results that were relatively unchanged from period one and, therefore, while they have been updated in the online dashboard, to improve the readability of this report, those results are not included in the report.
The reported QPIs in the Lung Cancer Quality Improvement Monitoring Report 2025:
- Routes to diagnosis: Proportion of people with lung cancer who were diagnosed within 14 days after an acute admission to hospital or a visit to an emergency department (ED) (emergency presentation)
- Surgical resection: Proportion of people with non-small cell lung cancer (NSCLC) receiving surgical resection with curative intent
- Overall survival: Overall (all-cause) survival for people with lung cancer at one year from diagnosis
- Cancer treatment at end of life: Proportion of people with lung cancer who died (from any cause) and received systemic anti-cancer therapy (SACT) within 30 days prior to death.
Reports:
2025
- Lung Cancer Quality Improvement Monitoring Report 2025 (Word 2.28KB)
- Lung Cancer Quality Improvement Monitoring Report 2025 (PDF 1.66KB)
2021
- Lung Cancer Quality Improvement Monitoring Report 2021 (Word 1MB)
- Lung Cancer Quality Improvement Monitoring Report 2021 (PDF 2MB)
This data can also be viewed in Te Aho o Te Kahu Cancer Care Data Explorer.
Quality Performance Indicator Descriptions
The QPI descriptions report outlines the detailed evidence-based descriptions for each indicator including the numerator and denominator. This report should be read in conjunction with the monitoring reports. This document includes indicators that can be measured and those we term ‘aspirational’ that are important for clinical care quality improvement but currently there is no data available to measure and report on them.
2025
- Lung Cancer Quality Performance Indicator Descriptions (Word 251KB)
- Lung Cancer Quality Performance Indicator Descriptions (PDF 406KB)
2021
Quality Performance Technical Specifications
The QPI technical specifications report outlines method for calculating each QPI that is reported in the associated monitoring report. This method provides enough detail to replicate our calculations every three years. It provides information on data sources, numerator criteria, denominator criteria, relevant data codes and descriptions and data flow diagrams.
2025
- Lung cancer quality performance indicator technical specifications (Word 549KB)
- Lung cancer quality performance indicator technical specifications (PDF 861KB)
2021
- LCQI01 Route to diagnosis (Word 262 KB)
- LCQI01 Route to diagnosis (PDF 281 KB)
- LCQI03 Pathological diagnosis (Word 189 KB)
- LCQI03 Pathological diagnosis (PDF 239 KB)
- LCQI06 Surgical resection for lung cancer (Word 193 KB)
- LCQI06 Surgical resection for lung cancer (PDF 254 KB)
- LCQI07 Systemic anti-cancer therapy for lung cancer (Word 269 KB)
- LCQI07 Systemic anti-cancer therapy for lung cancer (PDF 339 KB)
- LCQI08 Radiation treatment (Word 319 KB)
- LCQI08 Radiation treatment (PDF 330 KB)
- LCQI09 Treatment survival (Word 295 KB)
- LCQI09 Treatment survival (PDF 324 KB)
- LCQI10 Overall survival (Word 288 KB)
- LCQI10 Overall survival (PDF 293 KB)
- LCQI11 Cancer treatment at end-of-life (Word 235 KB)
- LCQI11 Cancer treatment at end-of-life (PDF 294 KB)
Improvement Plan (Action Plan)
This action plan should be read in conjunction with the monitoring report. Districts can review the monitoring report to identify where their performance is significantly different to other districts. This can then lead to quality improvement principles to plan for and implement improvement projects in those areas.
The ‘recommended actions’ set out in this plan are intended as a guide to the types of actions districts or hospitals could take to improve their performance. Districts and hospitals can develop and implement local quality improvement plans with actions appropriate to their local context and priorities.
We note some districts and hospitals are already undertaking quality improvement work. The recommendations in this action plan do not prevent additional actions or the DHBs and hospitals continuing to follow existing effective quality improvement activities.
Te Aho o Te Kahu no longer publishes action plans; the most recent one was released in 2021.
National Lung Cancer Working Group
Role
In October 2009, the Regional Cancer Networks and the Ministry of Health Cancer Team invited clinicians and other parties with an interest in thoracic malignancy to a meeting to gain agreement on the development of a National Lung Cancer Working Group (NLCWG). The aim of this group has been to achieve national consistency in the care of patients with thoracic malignancy.
The NLCWG was formally established early 2010 once the terms of reference, membership, and a proposed work programme was agreed. The NLCWG has been responsible for developing several guidance documents, standards, and toolkits. It has maintained relationships with key stakeholders, as well as supported initiatives related to research, clinical education, and lung cancer public awareness campaigns.
Terms of reference
Word - National Lung Cancer Working Group Terms of Reference
PDF - National Lung Cancer Working Group Terms of Reference
Membership
Chair
In 2024–2025, the National Lung Cancer Working Group was chaired by James Entwisle, clinical leader, Radiology Department, Wellington Hospital, and comprised:
- Brendan Luey, consultant medical oncologist, Health New Zealand | Te Whatu Ora – Capital, Coast and Hutt Valley and Bowen Icon Cancer Centre
- Chris Harrington, consultant radiation oncologist, Health New Zealand | Te Whatu Ora Canterbury
- Claire Hardie, radiation oncologist, Health New Zealand | Te Whatu Ora MidCentral, and joint chair, central region lung group
- Dianne Keip, cancer care coordinator, Health New Zealand | Te Whatu Ora Hawke’s Bay
- Felicity Meikle, cardiothoracic specialist, Health New Zealand | Te Whatu Ora Waikato
- George Laking, medical oncologist, Health New Zealand | Te Whatu Ora – Auckland; chair of the Māori Health Committee of the Royal Australasian College of Physicians; and board member of Hei Āhuru Mōwai Māori Cancer Leadership Aotearoa
- Greg Frazer, respiratory and general physician, Health New Zealand | Te Whatu Ora Canterbury, and clinical senior lecturer, University of Otago
- Jeremy Hyde, pathologist, Awanui Labs, Nelson
- Jonathan Adler, consultant palliative care, Health New Zealand | Te Whatu Ora Capital, Coast and Hutt Valley
- Joseph Stafford, consumer and Māori representative
- Mark Taylor, clinical director of primary and integrated care, Health New Zealand | Te Whatu Ora Waikato, and specialist general practitioner
- Paul Conaglen, cardiothoracic specialist, Health New Zealand | Te Whatu Ora Waikato, and chair, Te Manawa Taki lung group
- Paul Dawkins, respiratory physician, Health New Zealand | Te Whatu Ora Counties Manukau
- Rob McNeill, chair of the Northern Region Lung Cancer Working Group and senior lecturer, Faculty of Medical and Health Sciences, University of Auckland
- Ross Lawrenson, Professor of Population Health and director of medicine, University of Waikato
- Sean Galvin, cardiothoracic surgeon and joint chair, central region lung group.
A special thank you to the sub-working group, to which the National Lung Cancer Working Group delegated, for working closely with Te Aho o Te Kahu to complete the 2025 lung cancer quality performance indicator update project. The sub-working group comprised:
- Chris Harrington
- James Entwisle
- Paul Dawkins
- Ross Lawrenson.
Minutes
NLCWG Minutes 29 November 2022
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