Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, Tennessee.
International Association for the Study of Lung Cancer, Aurora, Colorado.
J Thorac Oncol. 2020 Sep;15(9):1434-1448. doi: 10.1016/j.jtho.2020.05.002. Epub 2020 May 20.
Access to targeted therapies for lung cancer depends on the accurate identification of patients' biomarkers through molecular testing. The International Association for the Study of Lung Cancer (IASLC) conducted an international survey to evaluate perceptions on current practice and barriers to implementation of molecular testing.
We distributed the survey to IASLC members and other health care professionals around the world. The survey included a seven-question introduction for all respondents, who then answered according to one of three tracks: (1) requesting tests and treating patients, (2) performing and interpreting assays, or (3) tissue acquisition. Barriers to implementing molecular testing were provided in free-response fields. The chi-square test was used for regional comparisons.
A total of 2537 respondents from 102 countries participated. Most respondents who test and treat patients believe that less than 50% of patients with lung cancer in their country receive molecular testing, but reported higher rates within their own practice. Although many results varied by region, the five most frequent barriers cited in all regions were cost, quality and standards, access, awareness, and turnaround time. Many respondents expressed dissatisfaction with the current state of molecular testing for lung cancer, including 41% of those performing and interpreting assays. Issues identified included trouble understanding results (37%) and the quality of the samples (23% reported >10% rejection rate). Despite concerns regarding the quality of testing, 47% in the performing and interpreting track stated there is no policy or strategy to improve quality in their country. In addition, 33% of respondents who request tests and treat patients were unaware of the most recent College of American Pathologists, IASLC, and Association for Molecular Pathology guidelines for molecular testing.
Adoption of molecular testing for lung cancer is relatively low across the world. Barriers include cost, access, quality, turnaround time, and lack of awareness.
肺癌的靶向治疗需要通过分子检测准确识别患者的生物标志物。国际肺癌研究协会（IASLC）进行了一项国际调查，以评估对当前分子检测实践和实施障碍的看法。
我们向 IASLC 成员和世界各地的其他医疗保健专业人员分发了调查。该调查包括所有受访者的七个问题介绍，然后根据以下三个轨道之一回答：（1）要求进行测试并治疗患者，（2）进行和解释检测，或（3）组织采集。在自由回答字段中提供了实施分子检测的障碍。使用卡方检验进行区域比较。
共有来自 102 个国家的 2537 名受访者参加。大多数进行测试和治疗的患者认为，其所在国家不到 50%的肺癌患者接受了分子检测，但在自己的实践中报告的比例更高。尽管许多结果因地区而异，但所有地区最常提到的五个障碍是成本、质量和标准、获取途径、意识和周转时间。许多受访者对当前的肺癌分子检测状况表示不满，包括 41%的进行和解释检测的受访者。确定的问题包括难以理解结果（37%）和样本质量（23%报告> 10%的拒收率）。尽管对检测质量存在担忧，但在进行和解释检测的轨道中有 47%的人表示，他们所在的国家没有改善质量的政策或策略。此外，33%的要求进行测试和治疗的患者不知道美国病理学家学会、IASLC 和分子病理学协会最近的分子检测指南。
全球范围内，肺癌的分子检测采用率相对较低。障碍包括成本、获取途径、质量、周转时间和缺乏意识。
