Regional differences in the detection of lung cancer are evident in Finland. This was a key finding in the newly published report examining the implementation and outcomes of lung cancer treatment in Finland between the years 2019–2023.
“The new lung cancer report supports previous findings on regional differences in detection phase diagnostics, as well as improves our understanding on topics such as treatment aims. National registries provide much-needed information on the implementation of treatment in Finland. Of course, clear areas for development were also identified, such as the poor coverage of clinical cancer staging data”, comments director of the Finnish Cancer Registry, Janne Pitkäniemi.
The report examined what information on the medical examination and treatment of lung cancer is accumulated in national registers, and what they tell about the implementation of treatment in Finland. In addition, compliance to recording practices and the coverage of essential clinical data, as well as the distribution of treatments, were evaluated. The results were then compared by region.
The report focuses on three new points of view: implementation of multidisciplinary team (MDT) meetings, the proportion of patients referred for curative treatment, as well as the comprehensiveness of cancer staging data.
Regional differences in diagnostics – lung cancer is often detected late
Data from the report showed that for approximately one fifth of patients, no cancer cell type had been recorded, and not all diagnoses were based on tissue or cell samples. The proportion of missing data clearly varied according to region.
“Using information provided by quality registries, we are able to detect possible differences and deviations in treatment implementation and outcomes. However, it’s even more important that these observations lead to further investigation of causes and concrete improvements, both regionally and on a national level”, states Timo Nykopp, Chief Physician of the Finnish Cancer Center FICAN.
The findings of the report also clearly indicate that lung cancer is often not detected until at an advanced stage. Approximately one fourth (27%) of patients are directed to curative treatment.
“In Finland lung cancer is often detected too late. When the diagnosis is given at an advanced stage, the likelihood of the patient receiving curative treatment is significantly reduced. Due to this, it is essential to improve early and fluent diagnostics, as well as coherent treatment practices”, highlights clinical specialist Heidi Andersén.
Incomplete data limits the formation of a full picture
Based on the report, a central issue is faced in data quality, coverage and access.
Not all information essential to treatment is available through the national registries. In some cases, data is not recorded or is not transferred to national databases, due to which they can not be utilized in the report materials.
For example, information on multidisciplinary team (MDT) meetings was scarcely available, meaning no conclusions can be drawn on MDT-activities based on the data recorded in the care register.
Information on cancer stage was missing for nearly half of the patients, which signifies shortcomings in the recording of clinical cancer reports. This makes it difficult to determine what stage a cancer is detected at and what type of treatment the patient is directed to.
“More work is needed to achieve a sufficient chain of knowledge generation. This will require data specifiers, information system suppliers, information administrators in welfare areas, and professionals who record data to examine their own activities and practices”, says Jonna Salonen, Director of quality registry activities at THL.
“We also need to continue investigating the best and most useful sources of information. Next we will be studying how necessary data can be extracted from the Kanta-services patient data pool, which is used, for example, as a source of data in the THL diabetes risk registry”, Salonen continues.
Reviewing the results of the report will be continued in national collaboration between professionals. The aim is to acquire a deeper understanding of the factors affecting the results, find solutions to recognized challenges, and support developmental work on a concrete level in order to make lung cancer treatment in Finland more effective.
The now published report is a part of the national Cancer quality registry -project, which aims to investigate what type of data is available in current registries, and how the data can be utilized in monitoring the quality of treatment in Finland.
More information:
Read the full report here (in Finnish): Keuhkosyöpä Suomessa 2019-2023 – Rekisteripohjainen katsaus diagnostiikkaan, hoitopolkuihin ja hoidon laatuun
Janne Pitkäniemi, Director / Finnish Cancer Registry
tel. 050 372 3335
firstname.surname@cancer.fi
Jonna Salonen, Director of quality registry activities / THL
tel. 029 524 7171
firstname.surname@thl.fi
Timo Nykopp, Chief Physician / Finnish Cancer Center FICAN
firstname.surname@hus.fi
