Understanding the Journey of Lung Cancer Patients in China: A Multi-center, Retrospective, Real-world study

Objective This retrospective, multi-center observational study aimed to investigate the patient journey of Chinese patients diagnosed with lung cancer (LC), focusing on the utilization of lung biopsy and surgical interventions. Methods Data were extracted from electronic medical records of three large tertiary hospitals with high cancer population in China. Adult patients (≥ 18 years) diagnosed with LC for the first time between January 1, 2019, and December 31, 2019, were identified. The data collection period spanned from 1 January 2018 to 1 June 2023. Patient demographics, clinical characteristics, diagnostic methods, and treatment pathways were analyzed using descriptive statistics. The Sankey diagram was used to visualize the patient flow among different clinical procedures including biopsy, imaging, surgery, and medical treatments from their initial visit to the last available follow-up visit. Results Data from a total of 8,095 patients diagnosed with LC were analyzed. At their first visit in the medical records during the study period, 919 patients (10.9%) received lung biopsy (percutaneous or bronchoscopy), 2,192 patients (27.1%) directly underwent surgical removal of the lesion without lung biopsy, and 539 patients (6.7%) received lung biopsy and surgery during the index visit. A significant portion of patients (2,069, 25.5%) received only imaging examinations at their first visit, with computed tomography being used in 73.8% of the cases. Another 823 (10.2%) started cancer treatment at their first visit, while the remainder (N = 1,586, 19.9%) did not receive any of these procedures. The rate of a repeated biopsy during follow-up was 2.3% in the group of 886 patients who received only lung biopsy at their first visit. Conclusion This study provides valuable insights into the diagnostic practices and clinical pathways for LC patients in China. The findings underscore the need for optimized diagnostic strategies, enhanced patient education to improve early detection, and more effective treatment.