Diagnostic Approach and Treatment of Lung Cancer Patients in Portugal: Portuguese Lung Cancer Study Group Survey

ABSTRACT

Introduction: In Portugal, in 2020, 5415 new lung cancer patients were diagnosed and 4797 deaths were caused by lung cancer. Lung cancer ranks third in terms of cancer incidence and is the leading cause of cancer mortality. Early diagnosis, complete and fast patient assessment and staging, multidisciplinary approach, access to personalized medicine, new treatment options and research are essential to improve survival and quality of life. Access to clinical trials is critical for this improvement.The aim of this study is to assess the techniques available to the diagnostic work-up, treatments, the waiting time and the needs perceived by physicians. Methods: The Portuguese Lung Cancer Study Group launched a survey in order to study the diagnostic approach and treatment of lung cancer patients in Portugal. An online survey with 47 questions was sent to all Portuguese hospitals that treat lung cancer, referring to the pre-COVID-19 pandemic experience. Results: Responses from 31 Portuguese hospitals were collected, between May and September 2020. Availability to bronchoscopy, image-guided transthoracic needle biopsy (TNB), endobronchial ultrasound- transbronchial needle aspiration (EBUS-TNBA), PET/CT, molecular biology testing is presented in table I. In 58% (n=18) the molecular biology test was performed as a "reflex test". About 68% (n=21) of hospitals used next generation sequencing. Two hospitals (7%) reported not having access to liquid biopsies.Video-assisted thoracoscopic surgery was the main surgical technique (61%;n=19). The waiting time for the first radiation oncology consultation was less than 15 days in 71% (n=26). About 61% (n=19) of hospitals had clinical trials. A wide majority of doctors (77%) would like to have more clinical trials. In 71% (n=22) of the hospitals, it was possible to refer patients to Palliative Care receiving systemic anticancer therapy. [Formula presented] Conclusions: Despite the limitations of the methods, this study allowed us to deepen our knowledge about the work-up technologies and treatments available for lung cancer patients in Portugal. It has also identified future opportunities, such as increasing accessibility to some diagnostic tools and clinical trials. Keywords Diagnosis and treatment approach, Lung Cancer in Portugal, Health Services Research - Portugal