Bulgarian exploratory analysis of time from diagnosis to treatment of lung cancer patients (Beat) - a retrospective database study on the patient pathway and time from diagnosis to treatment.

backgroundGlobocan data for 2020 rank lung cancer as the third most common malignancy (12.1%) and the deadliest cancer (18.3%) in Bulgaria. The current study aims to analyze lung cancer patient pathways and time to treatment from diagnosis based on real-world data.

methodsWe conducted an observational database study based on the secondary use of data collected for other purposes for 3 years (2020-2022). The main outcomes of interest were time from diagnosis to therapy measured in days on national and regional levels, stratified by therapy type and year and number of newly diagnosed patients with lung cancer in each of the years for the observed period. Data were analyzed through descriptive statistics.

resultsThroughout the observed period, 8,585 patients were newly diagnosed with lung cancer, averaging approximately 2,861 diagnoses per year. Most patients' records reported non-small cell lung cancer (4536, 64%), Furthermore, most patients were diagnosed with advanced stages of cancer, with 61% (4297) being diagnosed with Stage IV. Time from Diagnosis to First Treatment (median) outcome showed variance by regions and type, from 7 to 40 days in the case of surgical treatment and 26 to 85 days in the case of combination therapy. The time from Diagnosis to First Systemic Treatment indicator shows a median delay between diagnosis to treatment of 42 days.

conclusionsThe study confirms that dynamic patient registers are crucial for performing real-world studies of treatment patterns and identifying gaps and inequities on a national level. There is a significant need to address the lack of screening programs for lung cancer in Bulgaria and ensure more equitable distribution of oncology centers.