Abstract
BackgroundThis study aimed to present the performance of the National Cancer Network’s (NCN) pilot program in the Lower Silesian Voivodeship (southwestern province of Poland with a population of 2,9 million in 2019), to analyse measures describing lung cancer patients and to determine whether those measures can be used to improve the treatment outcomes of stage III and IV patients with lung cancer in Poland.MethodsThree measures of the NCN pilot programme were analysed: “Percentage of patients with genetic and molecular testing for predictive factors”, “Assessment of the completeness of a pathological examination”, and “Percentage of stage III and IV cancer patients”. As many as 2,218 patients with ICD-10-CM Diagnosis Code C34 were included in the NCN pilot program from 1 to 2019 to 31 December 2020, in the Lower Silesian Voivodeship. The scores of each measure were calculated quarterly by the Regional Coordinating Centre, Wroclaw Comprehensive Cancer Center, Wroclaw, Poland.ResultsGenetic and molecular testing among stage III and IV patients was performed in only 40% and 60% of patients, respectively. The incompleteness of histopathological examinations did not exceed 0.5%. Stage III and stage IV patients accounted for 37% and 35% of the analysed patients, respectively.ConclusionsThe NCN pilot program measures presented in this study appear to be highly sensitive, simple, and transparent tools to monitor the quality of lung cancer diagnosis and assess clinical staging in patients within a specific region.An increase in the proportion of stage III and IV patients who will undergo genetic and molecular testing in the era of modern drug therapies should result in improved treatment outcomes in this patient group. In the present analysis, the values of the main analysed measure, which evaluates the number of genetic and molecular tests for predictive factors for lung cancer, were subject to significant fluctuations during the pilot project. Both upwards and downwards trends were observed. Further analysis in the future is warranted to eliminate the unfavourable factors influencing the obtained values of the measure.
Highlights
Cancer is currently the largest organisational and economic challenge facing the health care system in Poland in the third decade of the 21st century.Demographic data show a progressive change in the Polish population structure, with an increasing proportion of persons aged older than 60 years
An increase in the proportion of stage III and IV patients who will undergo genetic and molecular testing in the era of modern drug therapies should result in improved treatment outcomes in this patient group
The network should be considered an organisational structure in the voivodeship, which includes the Regional Coordinating Centre (RCC) and Level I and II centres included in the pilot study
Summary
Demographic data show a progressive change in the Polish population structure, with an increasing proportion of persons aged older than 60 years. The proportion of the elderly population is predicted to reach 40% by 2050 [1]. The abovementioned trend coincides with an observed increase in the incidence of malignant neoplasms. By 2040, according to WHO data, the incidence of malignant neoplasms in Poland is expected to increase by 20%. In the over-60 age group, it may even exceed 30% [2]. This study aimed to present the performance of the National Cancer Network’s (NCN) pilot program in the Lower Silesian Voivodeship (southwestern province of Poland with a population of 2,9 million in 2019), to analyse measures describing lung cancer patients and to determine whether those measures can be used to improve the treatment outcomes of stage III and IV patients with lung cancer in Poland
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