Abstract
The majority of lung cancer patients are diagnosed with an advanced stage IV, which has short survival time. Many lung cancer patients have comorbidities, which influence treatment and patients’ quality of life. The aim of the study is to describe comorbidities in incident lung cancer patients and explore their attendance of ambulatory care physicians in Germany. In the observed period, 13,111 persons were first diagnosed with lung cancer (1-year incidence of 36.4 per 100,000). The mean number of comorbidities over 4 quarters was 30.77 ± 13.18; mean Charlson Comorbidity Index was 6.66 ± 2.24. In Germany, ambulatory care physicians most attended were general practitioners (2.6 quarters with contact within 4 quarters). Lung cancer was diagnosed by a general practitioner in 38% of the 13,111 incident patients. The average number of ambulatory care physician contacts over 4 quarters was 35.82 ± 27.31. High numbers of comorbidities and contacts in ambulatory care are common in patients with lung cancer. Therefore, a cross-sectoral and interdisciplinary approach is required for effective, patient-centred care. This was a 5-year cross-sectoral study, based on the InGef research database, which covers anonymized health insurance data of 7.2 million individuals in Germany. Incident lung cancer patients in a 5-year period (2013–2017) were identified. Descriptive statistics were calculated for sociodemographic characteristics, comorbidities, and attendance of ambulatory care physicians.
Highlights
Despite improved diagnostic and treatment options, lung cancer remains one of the most malignant diseases and the leading cause of cancer-related deaths worldwide[1]
Prevalence Out of the sample of 4.9 million patients, 3,275,709 were constantly insured, and of these, 20,802 persons had the diagnosis lung cancer in the period 2013–2017
This study documented the number of incident lung cancer patients in Germany and their most frequent and number of comorbidities, the Charlson Comorbidity Index, contacts to ambulatory care physicians, differences between federal states and ambulatory care physicians who made the initial diagnosis of lung cancer in Germany in incident lung cancer patients
Summary
Despite improved diagnostic and treatment options, lung cancer remains one of the most malignant diseases and the leading cause of cancer-related deaths worldwide[1]. Due to the fact that lung cancer is most frequent in men in the age of 80–84 years and women in the age of 70–74 years, consideration of comorbidities during treatment planning should receive more attention[5]. Most clinical guidelines of cancer treatment do not reflect the complex inter-relation between cancer and comorbidity but instead pursue a “single disease” approach in management[6]. Data on comorbidities, along with patient demographics, is essential for comprehensive treatment and care in lung cancer. Such data are required to enhance clinical decision-making and supportive tools, as well as the design and planning of healthcare services for patients with lung cancer[6,8,9]
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