Comparative study of lung cancer care and survival outcomes across the Nordic countries

Background: Lung cancer (LC) is the leading cause of cancer-related deaths worldwide. Despite societal, economic and genetic similarities, 5-year age-standardized relative survival rate is lower in Finland compared to the other Nordic countries. Previous studies have identified discrepancies in LC g...

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Main Authors: Ghida Khalife, Juho Waris, Uffe Bødtger, Johan Isaksson, Kirill Neumann, Hrönn Harðardóttir, Heidi Andersén, Antti Jekunen, Maria Lovén, Tuula Vasankari, Susanna Nurmi-Rantala, Paulus Torkki
Format: Article
Language:English
Published: Medical Journals Sweden 2025-06-01
Series:Acta Oncologica
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Online Access:https://medicaljournalssweden.se/actaoncologica/article/view/42778
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author Ghida Khalife
Juho Waris
Uffe Bødtger
Johan Isaksson
Kirill Neumann
Hrönn Harðardóttir
Heidi Andersén
Antti Jekunen
Maria Lovén
Tuula Vasankari
Susanna Nurmi-Rantala
Paulus Torkki
author_facet Ghida Khalife
Juho Waris
Uffe Bødtger
Johan Isaksson
Kirill Neumann
Hrönn Harðardóttir
Heidi Andersén
Antti Jekunen
Maria Lovén
Tuula Vasankari
Susanna Nurmi-Rantala
Paulus Torkki
author_sort Ghida Khalife
collection DOAJ
description Background: Lung cancer (LC) is the leading cause of cancer-related deaths worldwide. Despite societal, economic and genetic similarities, 5-year age-standardized relative survival rate is lower in Finland compared to the other Nordic countries. Previous studies have identified discrepancies in LC guidelines, but research on actual care practices remains limited. We aim to address this knowledge gap by conducting a comprehensive examination of the current care practices for LC patients in the Nordic countries. Methods: We employed a non-interventional, prospective study design. We conducted an expert workshop involving LC specialists from Finland to formulate relevant questions for a structured survey. This survey was distributed to healthcare professionals (HCPs) across Nordic hospitals and primary care units. The survey results were then analyzed, and a follow-up Nordic LC expert workshop was held to identify the most relevant factors potentially influencing LC survival outcomes. Results: Four key differences in care practices between Finland and other Nordic countries were identified: (1) resources available in primary care units, (2) waiting times in primary care, (3) availability of novel treatments and (4) tracking of LC survival and mortality outcomes by the hospital. Finland has the lowest access to computed tomography (CT) from primary care, longest waiting times in primary care, and lacks a national outcome tracking system. Some medical doctors in Finland and Iceland highlighted observed limitations in specific cases involving access to neoadjuvant immunotherapy and chemotherapy. Interpretation: Several factors unrelated to specialized LC care are likely contributing to poorer 5-year survival rates for LC in Finland. These findings may be applicable to other healthcare systems as well.
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spelling doaj-art-7c13c9b698cb4defba9e36fd417e53a92025-08-20T03:07:47ZengMedical Journals SwedenActa Oncologica1651-226X2025-06-016410.2340/1651-226X.2025.42778Comparative study of lung cancer care and survival outcomes across the Nordic countriesGhida Khalife0https://orcid.org/0009-0003-6756-8098Juho Waris1Uffe Bødtger2https://orcid.org/0000-0002-1231-9209Johan Isaksson3https://orcid.org/0000-0001-5787-0072Kirill Neumann4https://orcid.org/0009-0007-2513-0871Hrönn Harðardóttir5https://orcid.org/0000-0002-1421-1461Heidi Andersén6https://orcid.org/0000-0001-5923-5865Antti Jekunen7https://orcid.org/0000-0002-6183-0169Maria Lovén8https://orcid.org/0000-0003-4561-3831Tuula Vasankari9https://orcid.org/0000-0002-1413-8970Susanna Nurmi-Rantala10https://orcid.org/0009-0003-2161-903XPaulus Torkki11https://orcid.org/0000-0002-1127-4205Department of Public Health, University of Helsinki, Helsinki, FinlandDepartment of Public Health, University of Helsinki, Helsinki, FinlandRespiratory Research Unit PLUZ, Department of Internal and Respiratory Medicine, Zealand University, Hospital Roskilde & Nastved, Næstved, Denmark; Institute of Regional Health Research, University of Southern Denmark, Odense, DenmarkCentre for Research and Development, Gävle County/Uppsala University, Uppsala, SwedenPulmonary Department, Akershus University Hospital, Oslo, NorwayDepartment of Respiratory Medicine, Landspitali University Hospital, Reykjavik, IcelandCancer Clinic, Vaasa Central Hospital, Vaasa, Finland; Finnish Lung Health Association (FILHA), Helsinki, Finland; Faculty of Medicine, Oncology Department, University of Turku, Turku, FinlandCancer Clinic, Vaasa Central Hospital, Vaasa, Finland; Finnish Lung Health Association (FILHA), Helsinki, FinlandDepartment of Public Health, University of Helsinki, Helsinki, FinlandFinnish Lung Health Association (FILHA), Helsinki, Finland; University of Turku, Department of Pulmonary Diseases and Clinical Allergology, Turku, FinlandMSD Finland, Espoo, FinlandDepartment of Public Health, University of Helsinki, Helsinki, FinlandBackground: Lung cancer (LC) is the leading cause of cancer-related deaths worldwide. Despite societal, economic and genetic similarities, 5-year age-standardized relative survival rate is lower in Finland compared to the other Nordic countries. Previous studies have identified discrepancies in LC guidelines, but research on actual care practices remains limited. We aim to address this knowledge gap by conducting a comprehensive examination of the current care practices for LC patients in the Nordic countries. Methods: We employed a non-interventional, prospective study design. We conducted an expert workshop involving LC specialists from Finland to formulate relevant questions for a structured survey. This survey was distributed to healthcare professionals (HCPs) across Nordic hospitals and primary care units. The survey results were then analyzed, and a follow-up Nordic LC expert workshop was held to identify the most relevant factors potentially influencing LC survival outcomes. Results: Four key differences in care practices between Finland and other Nordic countries were identified: (1) resources available in primary care units, (2) waiting times in primary care, (3) availability of novel treatments and (4) tracking of LC survival and mortality outcomes by the hospital. Finland has the lowest access to computed tomography (CT) from primary care, longest waiting times in primary care, and lacks a national outcome tracking system. Some medical doctors in Finland and Iceland highlighted observed limitations in specific cases involving access to neoadjuvant immunotherapy and chemotherapy. Interpretation: Several factors unrelated to specialized LC care are likely contributing to poorer 5-year survival rates for LC in Finland. These findings may be applicable to other healthcare systems as well. https://medicaljournalssweden.se/actaoncologica/article/view/42778Lung cancercare practicestreatment outcomessurvival rateNordic countries
spellingShingle Ghida Khalife
Juho Waris
Uffe Bødtger
Johan Isaksson
Kirill Neumann
Hrönn Harðardóttir
Heidi Andersén
Antti Jekunen
Maria Lovén
Tuula Vasankari
Susanna Nurmi-Rantala
Paulus Torkki
Comparative study of lung cancer care and survival outcomes across the Nordic countries
Acta Oncologica
Lung cancer
care practices
treatment outcomes
survival rate
Nordic countries
title Comparative study of lung cancer care and survival outcomes across the Nordic countries
title_full Comparative study of lung cancer care and survival outcomes across the Nordic countries
title_fullStr Comparative study of lung cancer care and survival outcomes across the Nordic countries
title_full_unstemmed Comparative study of lung cancer care and survival outcomes across the Nordic countries
title_short Comparative study of lung cancer care and survival outcomes across the Nordic countries
title_sort comparative study of lung cancer care and survival outcomes across the nordic countries
topic Lung cancer
care practices
treatment outcomes
survival rate
Nordic countries
url https://medicaljournalssweden.se/actaoncologica/article/view/42778
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