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. 2022 Nov 25:12:1032366.
doi: 10.3389/fonc.2022.1032366. eCollection 2022.

Underlying reasons for post-mortem diagnosed lung cancer cases - A robust retrospective comparative study from Hungary (HULC study)

Zolta N Kiss  1 , Krisztina Bogos  2 , Lilla Tamási  3 , Gyula Ostoros  2 , Veronika Müller  3 , Nóra Bittner  4 , Veronika Sárosi  5 , Aladár Vastag  1 , Kata Knollmajer  1 , Máté Várnai  1 , Krisztina Kovács  1 , Andrea Berta  1 , István Köveskuti  1 , Eugenia Karamousouli  1 , György Rokszin  6 , Zsolt Abonyi-Tóth  6   7 , Zsófia Barcza  8 , István Kenessey  9   10 , András Weber  11   12 , Péter Nagy  11   13   14 , Petra Freyler-Fadgyas  15 , Miklós Szócska  16   17 , Péter Szegner  16   17 , Lászlóné Hilbert  18 , Gabriella Branyiczkiné Géczy  18 , György Surján  16 , Judit Moldvay  19   20 , Zoltán Vokó  21 , Gabriella Gálffy  22   23 , Zoltán Polányi  1
Affiliations

Underlying reasons for post-mortem diagnosed lung cancer cases - A robust retrospective comparative study from Hungary (HULC study)

Zolta N Kiss et al. Front Oncol. .

Abstract

Objective: The Hungarian Undiagnosed Lung Cancer (HULC) study aimed to explore the potential reasons for missed LC (lung cancer) diagnosis by comparing healthcare and socio-economic data among patients with post-mortem diagnosed LC with those who were diagnosed with LC during their lives.

Methods: This nationwide, retrospective study used the databases of the Hungarian Central Statistical Office (HCSO) and National Health Insurance Fund (NHIF) to identify patients who died between January 1, 2019 and December 31, 2019 and were diagnosed with lung cancer post-mortem (population A) or during their lifetime (population B). Patient characteristics, socio-economic factors, and healthcare resource utilization (HCRU) data were compared between the diagnosed and undiagnosed patient population.

Results: During the study period, 8,435 patients were identified from the HCSO database with LC as the cause of death, of whom 1,203 (14.24%) had no LC-related ICD (International Classification of Diseases) code records in the NHIF database during their lives (post-mortem diagnosed LC population). Post-mortem diagnosed LC patients were significantly older than patients diagnosed while still alive (mean age 71.20 vs. 68.69 years, p<0.001), with a more pronounced age difference among female patients (difference: 4.57 years, p<0.001), and had significantly fewer GP (General Practitioner) and specialist visits, X-ray and CT scans within 7 to 24 months and 6 months before death, although the differences in GP and specialist visits within 7-24 months did not seem clinically relevant. Patients diagnosed with LC while still alive were more likely to be married (47.62% vs. 33.49%), had higher educational attainment, and had more children, than patients diagnosed with LC post-mortem.

Conclusions: Post-mortem diagnosed lung cancer accounts for 14.24% of total lung cancer mortality in Hungary. This study provides valuable insights into patient characteristics, socio-economic factors, and HCRU data potentially associated with a high risk of lung cancer misdiagnosis.

Keywords: delayed diagnosis; late stage; lung cancer; lung cancer mortality; post-mortem diagnoses.

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Conflict of interest statement

Authors ZK, AV, KKn, MV, KKo, AB, IKö, EK and ZP are employed by MSD Pharma Hungary Ltd. ZV is employed by Semmelweis University where his contribution to this project was financially compensated. KB, JM and GyO are employees of National Korányi Institute of Pulmonology and have received speaker honorarium from MSD Hungary. GabG is employee of Oncology Center of Törökbálint and has received speaker honorarium from MSD Hungary. ZsB is employee of Syntesia Ltd. and her contribution to this project was financially compensated. The programme is financed by MSD Pharma Hungary Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Patient populations included in the HULC study. HULC, Hungarian Undiagnosed Lung Cancer.
Figure 2
Figure 2
Mean annual number of GP visits, specialist visits, and hospital days within 7–24 months (blue) and 6 months (yellow) before the time of death among patients diagnosed with LC post-mortem (population A) or during their lives (population B). GP, general practitioner; LC, lung cancer.
Figure 3
Figure 3
Mean annual number of X-ray, chest CT or all types of CT scans within 7–24 months (blue) and 6 months (yellow) before the time of death among patients diagnosed with LC post-mortem (population A) or during their lives (population B). LC, lung cancer.
Figure 4
Figure 4
Autopsy rate (%) for all deaths in European countries (where data available). Source: WHO – European Health Information Gateway.
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References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A, et al. . Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer J Clin (2018) 7068(46):313394–424. doi: 10.3322/caac.21492 - DOI - PubMed
    1. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JWW, Comber H, et al. . Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. Eur J Cancer (2013) 49:1374–403. doi: 10.1016/j.ejca.2012.12.027 - DOI - PubMed
    1. Ferlay J, Colombet M, Soerjomataram I, Dyba T, Randi G, Bettio M, et al. . Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. European Journal of Cancer (2018) 103(2018):356–87. doi: 10.1016/j.ejca.2018.07.005 - DOI - PubMed
    1. Bogos K, Kiss Z, Gálffy G, Tamási L, Ostoros G, Müller V, et al. . Revising incidence and mortality of lung cancer in central Europe: An epidemiology review from Hungary. Front Oncol (2019) 9:1051. doi: 10.3389/fonc.2019.01051 - DOI - PMC - PubMed
    1. Tamási L, Horváth K, Kiss Z, Bogos K, Ostoros G, Müller V, et al. . Age and gender specific lung cancer incidence and mortality in Hungary: Trends from 2011 through 2016. Pathol Oncol Res POR (2021) 27:598862. doi: 10.3389/pore.2021.598862 - DOI - PMC - PubMed

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