Spain: Lung Cancer Country Profile
Spain performs only moderately across the scorecard: its best performance is in the fourth domain, while it performs particularly
poorly in the third domain—focussing on diagnosis. This poor performance is because the guidelines present neither timeframes
nor fast-tracking for diagnostic testing, nor a rapid referral pathway to secondary or tertiary care. Scores in the first domain,
on strategy, could be improved by the inclusion of a specific lung cancer control plan and details of the funding of the ‘National
Cancer Strategy ’ (although this is challenging because regions have their own systems). Also, guidelines mention neither screening
nor shared decision making. Moderately high performance in the public health domain is due to a lack of an evidence based
approach to screening and the absence of lung cancer patient organisations’ involvement in guideline development and HTAs.
Finally, middling performance in the fifth domain is because Spain’s cancer registry receives a high score only on a regional, not a
national basis, and the complete vital registration component is of medium quality. We discuss opportunities for improvement at
the end of this country profile.
Obtaining national-level information or consensus is challenging because the Spanish health system is devolved to regions. Plans
written at the national level are reinterpreted at regional levels and further reinterpreted at the hospital level. A unified national
approach via a national cancer control plan may help ensure equitable access. Workshop participants noted that one of the main
challenges for their healthcare system is building strong relationships between primary care and hospital-based specialists.
Summary scorecard
Domain Austria Belgium Finland France Netherlands Norway Poland Romania Spain Sweden UKLung cancer
is a strategic
priorityM
Lung cancer
is a public
health issueMH
Lung cancer
is a race
against timeL
Lung cancer
is at a
crossroadsH
Lung cancer
is a focus for
researchM
KeyLow Moderately low Moderate Moderately high HighSponsored by