Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals

Sylvia Genet; Esther Visser; Maggy Youssef-El Soud; Huub N.A. Belderbos; Gerben Stege; Marleen E.A. de Saegher; Susan C. van 't Westeinde; Luc Brunsveld; Maarten A.C. Broeren; Daan van de Kerkhof; Federica Eduati; Ben E.E.M. van den Borne; Volkher Scharnhorst

doi:10.1016/j.lungcan.2024.107477

Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals

Sylvia Genet
, Esther Visser
, Maggy Youssef-El Soud
, Huub N.A. Belderbos
, Gerben Stege
, Marleen E.A. de Saegher
, Susan C. van 't Westeinde
, Luc Brunsveld
, Maarten A.C. Broeren
, Daan van de Kerkhof
, Federica Eduati
, Ben E.E.M. van den Borne
, Volkher Scharnhorst (Corresponding author)

Research output: Contribution to journal › Article › Academic › peer-review

3 Citations (Scopus)

130 Downloads (Pure)

Abstract

OBJECTIVES: Timely diagnosis of lung cancer (LC) is crucial to achieve optimal patient care and outcome. Moreover, the number of procedures required to obtain a definitive diagnosis can have a large influence on the life expectancy of a patient. Here, adherence with existing Dutch guidelines for timeliness and type and number of invasive and imaging procedures was assessed.

MATERIALS AND METHODS: 1096 patients with suspected LC were enrolled in this multicenter prospective study (NL9146). The overall survival, time from referral to the first appointment with the pulmonologist, time to diagnosis and treatment, and the number of imaging and invasive procedures were evaluated. Patients were divided into different diagnostic groupsearly- and advanced stage non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), large cell neuroendocrine carcinoma of the lung (LCNEC), patients without LC and patients without a definitive diagnosis.

RESULTS: The majority of patients (66 %) received a definitive diagnosis within 5 weeks, although the time to diagnosis of early-stage LC patients and patients without LC was significantly longer comparted to advanced stage LC. An increase in invasive procedures was seen for early-stage LC compared to advanced stage LC and for 13 % of the advanced stage non-squamous NSCLC patients up to three additional invasive procedures were performed solely to obtain sufficient material for NGS. For patients without a definitive diagnosis, 50 % did undergo at least one invasive procedure, while 11 % did not wish to undergo any invasive procedures.

CONCLUSION: These insights could aid in improved LC diagnostics and efficient implementation of new techniques like liquid biopsy and artificial intelligence. This may lead to more timely LC care, a decreased number of invasive procedures, less variability between the diagnostic trajectory of different patients and aid in obtaining a definitive diagnosis for all patients.

Original language	English
Article number	107477
Number of pages	8
Journal	Lung Cancer
Volume	189
Early online date	22 Jan 2024
DOIs	https://doi.org/10.1016/j.lungcan.2024.107477
Publication status	Published - Mar 2024

Funding

The study was supported by The Netherlands Organization for Scientific Research (NWO) via LIFT grant 731.017.405. Supported by AstraZeneca grant AZNL201700295 and Catharina Onderzoeksfonds institutional fund grant 2017-02 (R.d.K.). We would like to acknowledge Remco de Kock (R.d.K) for his work in patient inclusion and data collection.

Funders	Funder number
AstraZeneca	AZNL201700295, 2017-02
Nederlandse Organisatie voor Wetenschappelijk Onderzoek	731.017.405

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Diagnostic procedures
Lung cancer care
Survival
Timeliness

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10.1016/j.lungcan.2024.107477

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Cite this

Genet, S., Visser, E., Youssef-El Soud, M., Belderbos, H. N. A., Stege, G., de Saegher, M. E. A., van 't Westeinde, S. C., Brunsveld, L., Broeren, M. A. C., van de Kerkhof, D., Eduati, F., van den Borne, B. E. E. M., & Scharnhorst, V. (2024). Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals. Lung Cancer, 189, Article 107477. https://doi.org/10.1016/j.lungcan.2024.107477

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title = "Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals",

abstract = "OBJECTIVES: Timely diagnosis of lung cancer (LC) is crucial to achieve optimal patient care and outcome. Moreover, the number of procedures required to obtain a definitive diagnosis can have a large influence on the life expectancy of a patient. Here, adherence with existing Dutch guidelines for timeliness and type and number of invasive and imaging procedures was assessed.MATERIALS AND METHODS: 1096 patients with suspected LC were enrolled in this multicenter prospective study (NL9146). The overall survival, time from referral to the first appointment with the pulmonologist, time to diagnosis and treatment, and the number of imaging and invasive procedures were evaluated. Patients were divided into different diagnostic groupsearly- and advanced stage non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), large cell neuroendocrine carcinoma of the lung (LCNEC), patients without LC and patients without a definitive diagnosis.RESULTS: The majority of patients (66 \%) received a definitive diagnosis within 5 weeks, although the time to diagnosis of early-stage LC patients and patients without LC was significantly longer comparted to advanced stage LC. An increase in invasive procedures was seen for early-stage LC compared to advanced stage LC and for 13 \% of the advanced stage non-squamous NSCLC patients up to three additional invasive procedures were performed solely to obtain sufficient material for NGS. For patients without a definitive diagnosis, 50 \% did undergo at least one invasive procedure, while 11 \% did not wish to undergo any invasive procedures.CONCLUSION: These insights could aid in improved LC diagnostics and efficient implementation of new techniques like liquid biopsy and artificial intelligence. This may lead to more timely LC care, a decreased number of invasive procedures, less variability between the diagnostic trajectory of different patients and aid in obtaining a definitive diagnosis for all patients.",

keywords = "Diagnostic procedures, Lung cancer care, Survival, Timeliness",

author = "Sylvia Genet and Esther Visser and \{Youssef-El Soud\}, Maggy and Belderbos, \{Huub N.A.\} and Gerben Stege and \{de Saegher\}, \{Marleen E.A.\} and \{van 't Westeinde\}, \{Susan C.\} and Luc Brunsveld and Broeren, \{Maarten A.C.\} and \{van de Kerkhof\}, Daan and Federica Eduati and \{van den Borne\}, \{Ben E.E.M.\} and Volkher Scharnhorst",

year = "2024",

month = mar,

doi = "10.1016/j.lungcan.2024.107477",

language = "English",

volume = "189",

journal = "Lung Cancer",

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Genet, S, Visser, E, Youssef-El Soud, M, Belderbos, HNA, Stege, G, de Saegher, MEA, van 't Westeinde, SC, Brunsveld, L , Broeren, MAC , van de Kerkhof, D , Eduati, F, van den Borne, BEEM & Scharnhorst, V 2024, 'Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals', Lung Cancer, vol. 189, 107477. https://doi.org/10.1016/j.lungcan.2024.107477

TY - JOUR

T1 - Strengths and challenges in current lung cancer care

T2 - Timeliness and diagnostic procedures in six Dutch hospitals

AU - Genet, Sylvia

AU - Visser, Esther

AU - Youssef-El Soud, Maggy

AU - Belderbos, Huub N.A.

AU - Stege, Gerben

AU - de Saegher, Marleen E.A.

AU - van 't Westeinde, Susan C.

AU - Brunsveld, Luc

AU - Broeren, Maarten A.C.

AU - van de Kerkhof, Daan

AU - Eduati, Federica

AU - van den Borne, Ben E.E.M.

AU - Scharnhorst, Volkher

PY - 2024/3

Y1 - 2024/3

N2 - OBJECTIVES: Timely diagnosis of lung cancer (LC) is crucial to achieve optimal patient care and outcome. Moreover, the number of procedures required to obtain a definitive diagnosis can have a large influence on the life expectancy of a patient. Here, adherence with existing Dutch guidelines for timeliness and type and number of invasive and imaging procedures was assessed.MATERIALS AND METHODS: 1096 patients with suspected LC were enrolled in this multicenter prospective study (NL9146). The overall survival, time from referral to the first appointment with the pulmonologist, time to diagnosis and treatment, and the number of imaging and invasive procedures were evaluated. Patients were divided into different diagnostic groupsearly- and advanced stage non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), large cell neuroendocrine carcinoma of the lung (LCNEC), patients without LC and patients without a definitive diagnosis.RESULTS: The majority of patients (66 %) received a definitive diagnosis within 5 weeks, although the time to diagnosis of early-stage LC patients and patients without LC was significantly longer comparted to advanced stage LC. An increase in invasive procedures was seen for early-stage LC compared to advanced stage LC and for 13 % of the advanced stage non-squamous NSCLC patients up to three additional invasive procedures were performed solely to obtain sufficient material for NGS. For patients without a definitive diagnosis, 50 % did undergo at least one invasive procedure, while 11 % did not wish to undergo any invasive procedures.CONCLUSION: These insights could aid in improved LC diagnostics and efficient implementation of new techniques like liquid biopsy and artificial intelligence. This may lead to more timely LC care, a decreased number of invasive procedures, less variability between the diagnostic trajectory of different patients and aid in obtaining a definitive diagnosis for all patients.

AB - OBJECTIVES: Timely diagnosis of lung cancer (LC) is crucial to achieve optimal patient care and outcome. Moreover, the number of procedures required to obtain a definitive diagnosis can have a large influence on the life expectancy of a patient. Here, adherence with existing Dutch guidelines for timeliness and type and number of invasive and imaging procedures was assessed.MATERIALS AND METHODS: 1096 patients with suspected LC were enrolled in this multicenter prospective study (NL9146). The overall survival, time from referral to the first appointment with the pulmonologist, time to diagnosis and treatment, and the number of imaging and invasive procedures were evaluated. Patients were divided into different diagnostic groupsearly- and advanced stage non-small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC), large cell neuroendocrine carcinoma of the lung (LCNEC), patients without LC and patients without a definitive diagnosis.RESULTS: The majority of patients (66 %) received a definitive diagnosis within 5 weeks, although the time to diagnosis of early-stage LC patients and patients without LC was significantly longer comparted to advanced stage LC. An increase in invasive procedures was seen for early-stage LC compared to advanced stage LC and for 13 % of the advanced stage non-squamous NSCLC patients up to three additional invasive procedures were performed solely to obtain sufficient material for NGS. For patients without a definitive diagnosis, 50 % did undergo at least one invasive procedure, while 11 % did not wish to undergo any invasive procedures.CONCLUSION: These insights could aid in improved LC diagnostics and efficient implementation of new techniques like liquid biopsy and artificial intelligence. This may lead to more timely LC care, a decreased number of invasive procedures, less variability between the diagnostic trajectory of different patients and aid in obtaining a definitive diagnosis for all patients.

KW - Diagnostic procedures

KW - Lung cancer care

KW - Survival

KW - Timeliness

UR - https://www.scopus.com/pages/publications/85185151227

U2 - 10.1016/j.lungcan.2024.107477

DO - 10.1016/j.lungcan.2024.107477

M3 - Article

C2 - 38271919

SN - 0169-5002

VL - 189

JO - Lung Cancer

JF - Lung Cancer

M1 - 107477

ER -

Strengths and challenges in current lung cancer care: Timeliness and diagnostic procedures in six Dutch hospitals

Abstract

Funding

UN SDGs

Keywords

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