[Development of epidemiologic indicators in the diagnosis and therapy of pulmonary cancer in the Czech Republic 1970-1999]

Abstract

Background: Lung cancer (LC) remains serious medical and social problem. In US it represents the most frequent cause of malignancy-related deaths both in males and females. In Czech Republic about 6000 persons acquires LC each year. The aim of the study was to describe developmental trends of the mortality, methods of therapy and results of treatment in Czech Republic during the last 30 years.

Methods and results: Prevalence of LC in males reached maximum in the middle of seventies (104/100,000), in females it has still the increasing tendency, being highest in 1996 (22.8/100,000). Comparing the swiftness of diagnostics: In years 1985 to 1996 number of late diagnosed cases diminished and the operability of all diagnosed cases increased from 10.4% to 11.8% in males and from 9.4% to 11.2% in females. The most frequent type of LC is the epidermoid type reaching in 1998 52% of all cases in the CR and 47% of cases treated at the TRN department of the Second Medical Faculty. Result of the five years survival have been still unsatisfying, only 4% of males and 5.3% females live longer than five years. At the department of TRN of the Second Medical Faculty in years 1998 and 1999, 266 cases of LC were diagnosed. The male/female ratio was 2:1, 21.9% were at first or second stadium. Following treatment was employed: 24.4% of all diagnosed cases were sent to surgery, 40% underwent radiotherapy, 94.3% of patients with parvocellular LC and 22% of non parvocellular LC received chemotherapy.

Conclusions: In Czech Republic during the last 25 years numbers of males with LC stagnate at inacceptable high values, in females the incidence still progresses. Unsatisfying are the results of treatment, numbers of patients surviving longer than 5 years are lower than in most of developed countries. To improve the situation it would be necessary to limit smoking habits in the population, reassess possibilities of depiction of early phases of LC, and improve the therapy employing modern approaches as the neoadjuvant chemotherapy, contemporary chemotherapeutic regimes in combination with radiotherapy or surgical therapy.