Unveiling disparities in lung cancer care: a joint spatio-temporal analysis of multidisciplinary meeting presentation, supportive care screening, and diagnostic timeliness in Victoria.

This study used data from 12,970 lung cancer cases in the Victorian Lung Cancer Registry to evaluate three key clinical quality indicators (CQIs): multidisciplinary meeting (MDM) presentation, supportive care screening, and timely diagnosis, across both geography and time within Victoria, Australia.

Using a Bayesian hierarchical joint spatio-temporal shared-component model (implemented with INLA), the authors examined how these CQIs cluster and vary by local government area and year. About 35% of the overall variability in these indicators was attributable to shared spatial and temporal components, indicating that the three CQIs tend to co-occur in similar places and times.

• The shared temporal component showed a modest but steady improvement over the study period, suggesting system-level gains in overall lung cancer care quality.
• Indicator-specific temporal trends were not uniform, implying that progress in each CQI has followed different trajectories.

Spatially, shared risk patterns largely mirrored the individual CQI distributions, revealing regions with persistent and overlapping deficits in MDM presentation, supportive care screening, and timely diagnosis. These findings underscore substantial geographic and temporal inequities in lung cancer care delivery.

The authors conclude that improving lung cancer outcomes will require integrated, geographically targeted interventions aimed at simultaneously strengthening these three CQIs, rather than addressing them in isolation.