National Lung Cancer Audit Frequently Asked Questions
What dataset should be used?
Please see the LUCADA data manual v3.1.3, available in the downloads section
What does LUCADA stand for?
LUCADA stands for Lung Cancer Data
Who has agreed the outputs and supporting dataset?
The NLCA Clinical Reference Group (CRG) identified the priority outputs of the audit.
What software is to be used for collecting the LUCADA dataset?
The programme has commissioned the development of a web-based (NHSnet) audit
IT infrastructure system from the National Health Applications & Infrastructure
Services (NHS CFH).
What are the security arrangements for LUCADA?
Each organisation must first complete a data user certificate, this identifies all users
of the system and requires the signature of the Trust Caldicott Guardian.
Access to the system is controlled by centrally assigned user names and passwords.
The core system uses the same access and security controls as the Open Exeter
and CWT systems; named access is over a secure network through the Open Exeter
portal
Is it possible to upload data to the central database, rather than via the data
entry screens?
Yes, both CSV and XML file specifications are being developed for upload to the
central database.
When can an organisation start to use the audit application?
As soon as the registration has been processed and a password issued.
How long is a password valid for?
Passwords expire every 28 days and hence must be changed every 28 days. If a
password is not reset within the 28 day window, a call must be logged with the
helpdesk who will reset it.
If a password it not used for 6 months, the user account expires and a new account
must be applied for using the clinical audit form.
At what point should the Performance Status be recorded?
The Performance Status should be recorded at the point in time closest to the start of
treatment. It should be updated if it differs from the original Performance Status
entered.
Is there a proforma I can use to help me collect the audit data?
A proforma is available in the downloads section. As well as the full audit dataset it
also highlights the key fields that are essential for the audit.
What data should be entered into data field 5.5 (Cancer Care Plan Intent)?
There has been uncertainty around the correct interpretation of this field. This is
partly due to conflicting data definitions between LUCADA and “Cancer Waiting
Times” and partly due to differences in data definitions between lung cancer and
mesothelioma. Data Field 5.5 CANCER CARE PLAN INTENT should be used to
record the intention of the treatment which is planned for the patient at this point in
time.
Intent Plan
Curative (C)
Details
 Surgical resection (including ‘open and close' but excluding all
surgery on mesothelioma patients)
 Radical radiotherapy to primary site with potential for cure
 Chemotherapy in Limited Stage and/or Good Prognosis Small
Cell Carcinoma (e.g. using ‘Manchester' prognostic score)
 Adjuvant (or neo-adjuvant) chemotherapy (combined with
surgery) in Non-Small Cell Carcinoma
 Adjuvant radiotherapy in Small Cell carcinoma
 Prophylactic Cranial Irradiation
Palliative (P)

Specialist Palliative Care

Chemotherapy in Non-Small Cell Carcinoma (excepting
Adjuvant and Neo-adjuvant therapy)

Radiotherapy to primary tumour with palliative intent

Radiotherapy to site of secondary cancer
Brachytherapy (Endobronchial radiotherapy)
Other endobronchial treatments (e.g. laser therapy, diathermy,
cryotherapy, insertion of bronchial stent)
Chemotherapy in Extensive Stage and/or Poor Prognosis
Small Cell Carcinoma (e.g. using the ‘Manchester' prognostic
score)
Surgery for mesothelioma (EPP, debulking surgery and
pleurodesis)






Palliative supportive
care only (S)
Surgical Pleurodesis
Superior Vena Caval Stenting
This item implies follow up with the aim of identifying symptoms
and treating these if and when appropriate. Follow up could be
through primary care, secondary care and includes doctors, nurses
and Macmillan staff. The plan implies that no immediate treatment
is to be given but does not exclude the patient from having
treatment at a future date if the need arose.
No specific
anti-cancer
treatment (N)
Unknown (9)
It is highly unlikely that any treatment plan would be drawn up,
where the intention of the treatment is Unknown. The use of this
code should be carefully monitored.
Important messages:

All surgery in mesothelioma patients is to be classified as palliative (P)

Pleurodesis, whether medical or surgical, is to be classified as palliative (P)
EXAMPLES:
5.5
Scenario
C
Patient has clinical or histological diagnosis of lung cancer –
undergoes surgery with curative intent.
P
Patient has clinical or histological diagnosis of mesothelioma undergoes EPP, debulking or surgical pleurodesis.
P
Patient has clinical or histological diagnosis of lung cancer undergoes surgical or medical pleurodesis.
C
Patient has clinical or histological diagnosis of lung cancer undergoes potentially curative chemotherapy and also has surgical
or medical pleurodesis.
In the latter example, the pleurodesis is recorded as a palliative care intervention in
sections L41/L42.
What data should be entered into data field L29 (Treatment Planned)?
There has been uncertainty around the correct interpretation of these fields. This is
partly due to conflicting data definitions between LUCADA and “Cancer Waiting
Times” and partly due to differences in data definitions between lung cancer and
mesothelioma. Data Field L29 (TREATMENT PLANNED) should be used to record
the type of treatment regimen planned.
Code
Treatment
01
Surgery


For Lung Cancer patients (including clinical diagnoses) record here any surgical procedure under taken with the intention
of curing the patient.Do not record here any procedures
undertaken for purely diagnostic purposes – these should
beentered in the Care Plan / MDT section.
For Mesothelioma patients - it is accepted that all surgical
procedures in this group of patients are palliative. Please enter
any therapeutic procedures as surgery – other (E57.8). Do not
record here any procedures undertaken for purely diagnostic
purposes – these should be entered in the Care Plan / MDT
section.
02
Teletherapy / Radiotherapy
03
Chemotherapy
04
Brachytherapy
05
Palliative care
06
Active Monitoring
07
Sequential chemotherapy and radiotherapy
08
Concurrent chemotherapy and radiotherapy
09
Induction chemotherapy to downstage before surgery
10
Neo-adjuvant chemotherapy and surgery
11
Surgery followed by adjuvant chemotherapy
EXAMPLES:
L29
Scenario
01
Patient has clinical or histological diagnosis of lung cancer –
undergoes surgery with curative intent.
01
Patient has clinical or histological diagnosis of mesothelioma undergoes EPP, debulking or surgical pleurodesis.
05
Patient has clinical or histological diagnosis of lung cancer undergoes surgical or medical pleurodesis.
03
Patient has clinical or histological diagnosis of lung cancer undergoes potentially curative chemotherapy and also has surgical
or medical pleurodesis.
In the latter example, the pleurodesis is recorded as a palliative care intervention in
sections L41/L42.