Analysis of lung cancer measures of the National Cancer Network pilot study in Poland for potential improvement in the quality of advanced-stage lung cancer therapy

Abstract

Background 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. Methods Three 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. Results Genetic 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. Conclusions The 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.

The pilot project of the National Cancer Network in Poland: Assessment of the functioning of the National Cancer Network and results from quality indicators for lung cancer (2019–2021)

“…It is worth referring to an analysis of tests performed for genetic and molecular predictors in patients at clinical stages 3 and 4 and the epidemiological structure of this group of patients. Compared to the findings presented in that analysis, which cover the NCN’s period of functioning between 2019 and 2020 in Lower Silesia Province, the current study showed no significant differences in the scope of the analysed aspects [ 20 ]. Only the percentage of stage 3 patients who underwent an assessment of predictors decreased, from 40% at the end of 2020 to 35% at the end of 2021.…”