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印度国家癌症登记计划下各医院肺癌的临床谱:挑战与机遇

Clinical spectrum of lung cancer across hospitals under the National Cancer Registry Programme in India: Challenges and opportunities.

作者信息

Kumar Sunil, Nath Anita, Sudarshan Kondalli Lakshminarayana, Ramamoorthy Thilagavathi, Sakia Jyoutishman, Kumar Naveen, Deo Suryanarayana Vs, Jain Deepali, Malik Prabhat S, Mathur Prashant

机构信息

Department of Surgical Oncology, Institute Rotary Cancer Hospital (IRCH), All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, India.

Indian Council of Medical Research-National Centre for Disease Informatics and Research, ICMR Complex-Nirmal Bhavan, Bengaluru, Karnataka, India.

出版信息

Lung India. 2025 Jul 1;42(4):283-290. doi: 10.4103/lungindia.lungindia_569_24. Epub 2025 Jun 27.

Abstract

BACKGROUND AND OBJECTIVE

Lung cancer is one among the top five cancers in India, both in incidence and mortality and is thus, a significant public health challenge. The economic disparities among nations significantly contribute to differences observed in the management of lung cancer.

METHODS

This study analysed the clinical spectrum of lung cancer from several hospitals using data from the National Cancer Registry Programme concerning demographic characteristics of patients, histological variants, and diagnostic and management practices between 2012 and 2019. For this descriptive study, data was drawn from 96 Hospital-Based Cancer Registries. Altogether, all cases classified under ICD-10, C34.90 were included in this study.

RESULTS

The study findings revealed that most lung cancer cases occurred in males aged 50-74 years and females aged 45-69 years. Adenocarcinoma were the most common (39.7%) variety, almost twice higher than squamous cell carcinoma subtypes. The majority (50.7%) of the patients with lung cancer were detected with distant metastases. Low rates of surgery were observed among the patients who had localised/locoregional spread, while one third of the patients diagnosed at another facility reported to the treating hospital between 7 to 30 days after diagnosis.

CONCLUSION

This study highlights that delay in referral and subsequent treatment initiation are critical challenges in lung cancer care, including delayed diagnosis, limited treatment options, and a lack of streamlined referral processes. The study findings will be crucial for identifying the gaps in care and guiding strategies to improve early diagnosis and treatment of lung cancer.

摘要

背景与目的

在印度,肺癌在发病率和死亡率方面均位列五大癌症之一,因此是一项重大的公共卫生挑战。国家间的经济差异在很大程度上导致了肺癌治疗方面存在差异。

方法

本研究利用国家癌症登记计划的数据,分析了多家医院肺癌的临床特征,这些数据涉及2012年至2019年期间患者的人口统计学特征、组织学类型以及诊断和治疗方法。对于这项描述性研究,数据取自96个基于医院的癌症登记处。本研究纳入了所有归类于ICD - 10、C34.90的病例。

结果

研究结果显示,大多数肺癌病例发生在50 - 74岁的男性和45 - 69岁的女性中。腺癌是最常见的类型(39.7%),几乎是鳞状细胞癌亚型的两倍。大多数(50.7%)肺癌患者被检测出有远处转移。在局限性/局部区域扩散的患者中,手术率较低,而在其他机构确诊的患者中有三分之一在诊断后7至30天向治疗医院报告。

结论

本研究强调,转诊延迟和随后的治疗启动延迟是肺癌护理中的关键挑战,包括诊断延迟、治疗选择有限以及缺乏简化的转诊流程。研究结果对于识别护理差距以及指导改善肺癌早期诊断和治疗的策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b27e/12342216/772814d2c2b9/LI-42-283-g001.jpg

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