Increase in the Length of Lung Cancer Patient Pathway Before First-Line Therapy: A 6-Year Nationwide Analysis From Hungary

Zoltan Kiss, Krisztina Bogos, Lilla Tamási, Gyula Ostoros, Veronika Müller, László Urbán, Nóra Bittner, Veronika Sárosi, Aladár Vastag, Zoltán Polányi, Zsófia Nagy-Erdei, Kata Knollmajer, Máté Várnai, Balázs Nagy, Krisztián Horváth, György Rokszin, Zsolt Abonyi-Tóth, Zsófia Barcza, Judit Moldvay, Gabriella Gálffy and Zoltán Vokó (Pathology & Oncology Research, doi: 10.3389/pore.2021.1610041)


This study aimed to examine the characteristics of the lung cancer (LC) patient pathway in Hungary during a 6-years period.


This nationwide, retrospective study included patients newly diagnosed with LC (ICD-10 C34) between January 1, 2011, and December 31, 2016, using data from the National Health Insurance Fund (NHIF) of Hungary. The following patient pathway intervals were examined: system, diagnostic and treatment interval by age, gender, tumor type, study year and first-line LC therapy.


During the 6-years study period, 17,386 patients had at least one type of imaging (X-ray or CT/MRI) prior to diagnosis, and 12,063 had records of both X-ray and CT/MRI. The median system interval was 64.5 days, and it was 5 days longer among women, than in men (68.0 vs. 63.0 days). The median system interval was significantly longer in patients with adenocarcinoma compared to those with squamous cell carcinoma or small cell lung cancer (70.4 vs. 64.0 vs. 48.0 days, respectively). Patients who received surgery as first line treatment had significantly longer median system intervals compared to those receiving chemotherapy (81.4 vs. 62.0 days). The median system interval significantly increased from 62.0 to 66.0 days during the 6-years study period.


The LC patient pathway significantly increased in Hungary over the 6-years study period. There were no significant differences in the length of the whole LC patient pathway according to age, however, female sex, surgery as first-line treatment, and adenocarcinoma were associated with longer system intervals.