Belgium: Lung Cancer Country Profile
Belgium performs relatively well across all five domains, scoring ‘moderately high’ in the second, fourth and fifth domains,
‘moderate’ in the third, and ‘moderately low ’ in the first. To improve scores, Belgium needs to update their National Cancer Control
Plan, including an implementation schedule and funding source, and ideally create a lung cancer specific control plan. Guidelines
do not cover screening, shared decision-making, or supportive and palliative care. Neither do guidelines mention timeframes
for diagnostic testing nor rapid referral to secondary and tertiary care. Strengthening policies on tobacco and involving patient
organisations in HTAs can improve the score in the second domain, while the fourth may improve with the 2019 introduction of
joint evaluation and reimbursement of biomarker testing and treatment—although not all biomarkers (e.g. PD-L1) are included
yet. Inclusion of psychological burden of lung cancer, pathways for psychological support services and supportive and palliative
care in guidelines is also needed. We discuss opportunities for improvement at the end of this country profile.
As one of two countries participating in the NELSON trial, Belgium is well-placed to implement its findings and improve early
detection rates of lung cancer. The trial demonstrated a reduction in lung cancer mortality with CT screening of high-risk people:
individuals were recruited from population-based registries in Belgium and the Netherlands and compared ten-year outcomes
between those offered vs those not-offered screening with CT. Workshop participants discussed the importance of screening
and early detection. They also noted that awareness of lung cancer should be included in the guidelines used by primary care
physicians to assist in early disease detection.
Summary scorecard
Domain Austria Belgium Finland France Netherlands Norway Poland Romania Spain Sweden UKLung cancer
is a strategic
priorityML
Lung cancer
is a public
health issueMH
Lung cancer
is a race
against timeM
Lung cancer
is at a
crossroadsMH
Lung cancer
is a focus for
researchMH
KeyLow Moderately low Moderate Moderately high HighSponsored by