Lung disease is a major killer
The UK is lagging behind other Western European countries in relation to lung cancer treatment, an audit shows.
The study of 26,000 patients found only half of all lung cancer patients received any form of active treatment and only one in 10 received surgery.
There were also wide variations between the best- and worst-performing trusts across the UK.
The audit, the third of its kind, is published by the NHS Information Centre and the Royal College of Physicians.
It found an overall improvement in the quality of care given by hospitals in the UK, but some hospitals were failing to offer acceptable standards of practice in key aspects of care, including diagnosis and treatment.
The best trusts offered a service comparable in quality to anything available internationally - but overall both care and outcomes fell below those reported by other Western European countries.
The proportion of patients receiving any form of active anti-cancer treatment varied from 75% in the best-performing trusts, to just a third in the worst performing.
Overall, the proportion of lung cancer patients receiving any active anti-cancer treatment was 51%. This was up from 43% in 2005, but compares badly with, for instance Italy, where the figure was 75%.
The audit, based on the experiences of more than 26,000 patients, found 87% of cases were reviewed by a multi-disciplinary team of experts - again a rise since 2005.
However, surgery to cut away tumour tissue - the best hope of a cure - was carried out on only 10% of UK patients, compared with 20% in the Netherlands and 17.5% in Sweden.
Again, there was a wide variation, with patients at the best-performing trusts more than four times more likely to be given surgery than patients in the worst-performing trusts.
A detailed microscopic examination of tissue samples to confirm a diagnosis of cancer was made in 68% of patients, but the rate varied between trusts from fewer than 20% to more than 85%.
Experts say a rate of at least 75% should be acceptable practice.
The audit also found that the overall proportion of patients with small cell lung cancer - a less common form of lung cancer - receiving chemotherapy was low at 61.9%. Many trusts were achieving rates of at least 80%.
Tim Straughan, chief executive of the NHS Information Centre, said: "While there have been overall improvements in care since the previous audit in 2006, there's still a wide variation between hospitals which cannot be explained on the basis of differing patient profiles alone.
"Trusts need to look carefully at the areas where their performance varies with national averages and expected levels of attainment and address the underlying causes."
Hospital trusts are being offered a local action-planning toolkit to help them assess their performance, and drive up standards of care.
Gill Oliver, chair of the UK Lung Cancer Coalition said: "The UKLCC is disappointed to see the huge variation in lung cancer treatment and care across the country.
"The UKLCC will continue to press for lung cancer services to be raised to the level of the best."