Lung cancer in Poland. Too few patients benefit from modern treatment

Lung cancer care is a communicating vascular system. If we do not improve diagnostics, if we do not organize the entire process from diagnostics to treatment in a proper manner, we will never be able to improve the results and effectiveness of treatment – no matter how much we extend access to modern therapies, writes Prof. dr hab. n. med. Joanna Chorostowska-Wynimko, Secretary General of the European Society of Lung Diseases.

1. Lung cancer is one of the most common and poor prognosis malignancies
2. Unfortunately, as noted by prof. Joanna Chorostowska-Wynimko, in Poland, a small percentage of lung cancer patients undergo any systemic treatment
3. The data for 2020 show that only 17 percent. Polish patients benefit from modern treatment. This is three times less than the European average (50 percent).
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5. More information can be found on the Onet homepage

Report «Diagnosed but Untreated. How to improve access to innovative treatment in Europe for patients with advanced non-small cell lung cancer », prepared by the Swedish Institute of Healthcare Economics, shows that in Poland we deviate from the European standard in the organization of diagnosis and treatment of lung cancer. The significance of this report stems from the fact that the same algorithm was used for all European countries covered by the study and officially available data were analyzed – for Poland reported by the National Health Fund.

The study showed a rather sad reality of lung cancer patients in Poland; but not only the sick, because that is also a reality for doctors and other health care workers. Very moving is the – estimated by the authors of the report – the low percentage of Polish lung cancer patients undergoing any systemic treatment and the disproportionately large group of patients treated with chemotherapy.

Lung cancer in Poland. We have drug programs, but …

In Poland, access to modern therapies under the drug program of the Ministry of Health is very decent. It is an excellent treatment which, when applied correctly, significantly improves the prognosis, extends the life of many patients while maintaining its good quality. It is worth adding that modern therapies generally do not require hospitalization, treatment can be administered on an outpatient basis. It therefore has many benefits that allow people with lung cancer to live their lives to the fullest.

Unfortunately, the data presented in the report indicate that in 2020 the percentage of patients receiving modern treatment in Poland was significantly lower than the average expected value for European countries – 17%. against 50 percent And this despite the availability of molecularly targeted drugs (three drug groups) and inhibitors of immune checkpoints, i.e. the so-called immunotherapy, under the Ministry of Health program, both in the first and second line of treatment. The aforementioned drugs have revolutionized the therapy of lung cancer, in some patients they allow for long-term survival despite the advanced, disseminated form of the disease. Meanwhile, in Poland, for example, we have a three times lower percentage of patients treated with immunotherapy compared to Europe.

For the sake of reliability, it should be added that the previously cited data concern the year 2020. Meanwhile, in Poland, first-line immunotherapy was only available for reimbursement from 2019, and immunotherapy in combination with chemotherapy from the beginning of 2021.

1. Find out more: Lung cancer: Poland among the leaders in the number of cases and the number of deaths. Why?

I would like to believe that a similar analysis for the entire year 2021 would be much more beneficial. Unfortunately, the data from the National Health Fund from the first half of 2021, i.e. the period immediately after the introduction of combined immunochemotherapy, do not indicate an improvement in the trend and an increase in the number of patients qualified for modern treatment.

The report mirrors the key problems related to proper medical care for this group of patients, including those resulting from the nature of the disease and the lack of proper health education of the society, such as late reporting of patients or the high degree of complexity and complexity of the diagnostic process. Of course, these are universal problems, and not only Poland is struggling with them. However, the report shows that some countries are more effective at overcoming these barriers. They can also boast a significantly higher percentage of patients treated systemically, as well as patients treated modernly.

Further part below the video.

Lung cancer in Poland. Necessary radical change of care organization

The data from the report confirm what the communities of specialists involved in the care of lung cancer patients have been saying for many years: we have to face a radical organizational change in the care of this group of patients in Poland. It is not enough to make drugs available. This is, of course, very important and any change that improves the availability of modern therapies is very happy. However, in modern oncology, effective diagnostics is the key to success that opens the possibility of optimization and personalization of therapy. Therefore, random actions and changes to one element of the procedure will not bring a radical improvement in the situation of lung cancer patients. This, in my opinion, is the main message of this report.

Back in 2018, the Agency for Health Technology Assessment and Tariff System (AOTMiT), together with a group of experts representing medical specialties involved in the diagnosis and treatment of lung cancer, prepared a comprehensive project to change the organization of care for lung cancer patients. It was the first document of this rank. He strongly indicated that any changes must be comprehensive and include not only treatment, but also diagnostics. Because one of the main problems that frustrates us and negatively affects the effectiveness of treatment, as well as the life expectancy of patients, is the diagnostic delay.

Meanwhile, since 2019, for unclear reasons, the reimbursement of outpatient lung cancer diagnosis procedures has been drastically reduced – even by 66 percent. As a result, diagnostics are carried out only as part of hospitalization, which increases the delay and significantly increases the costs. Another problem is the lack of standardization of procedures, which translates, for example, into problems with the appropriate quantity and quality of biopsy material. It should also be remembered that comprehensive care for this group of patients is not only the confirmation of oncological diagnosis, but also the diagnosis and optimization of treatment of other diseases, very often of the respiratory and circulatory systems, because the success of oncological therapy depends to a large extent on the general condition of the patient. There is a pandemic overlapping all of this. There are regions in Poland where 90 percent. Pulmonary beds were renamed infectious, which drastically worsened the situation of people with respiratory diseases, including lung cancer. The remaining 10 percent was allocated to them. beds, which de facto means leaving these patients unattended. The same is true for people whose cancer has not yet been diagnosed but needs diagnosis for, for example, coughing or recurrent infections. The optimal solution (we described them in the report for AOTMiT) would be to establish coordinated lung cancer diagnostics and treatment centers. Not individual centers where all specialties are crammed under one roof, but networks of centers functionally interconnected with each other, providing all the required diagnostic and treatment procedures. The patient would receive help at every stage of the disease, from diagnosis to palliative treatment.

The article comes from the “Diagnosis: Cancer” campaign prepared by Warsaw Press and the media partner of which is the medTvoiLokony portal. All materials can be found at http://www.warsawpress.com/

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