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<25

Lung cancer incidence
(Rate per 100,000, 2017)

25-30

30-35

35-40

40-45

>45

Belgium

Scorecard results

Indicator Range Score Justification

Lung cancer is a strategic priority

1 Operational,

comprehensive, up to

date national cancer

control plan

0 – 5 1  A National Cancer Plan was published by the Ministry of Social Affairs and Public Health in

2008.^5
 There is no mention of an implementation plan. While the cancer plan states that it will be
accompanied from the outset by an evaluation mechanism, this is not an implementation
plan. The Reference Cancer Centre will publish an annual review of the results achieved
within the framework of the cancer plan.
 The plan mentions additional funding is available but does not explicitly state the sources
of funding.
 A specific lung cancer control plan has not been published by the government or health
ministry.
2 Comprehensive clinical
guidelines for lung
cancer

0 – 6 3  Lung cancer guidelines were published by KCE (the Belgian Health Care Knowledge

Centre) under the supervision of the Minister of Public Health and Social Affairs in 2013.^6

 The guidelines mention diagnosis and treatment.

 The guidelines do not mention screening, supportive / palliative care or shared decision

making.

Lung cancer is a public health issue

3 Tobacco control policies

and public health

measures

0 – 9 6  National objectives on tobacco control and a national agency for tobacco control exist.^7

 Belgium is party to World Health Organization (WHO) Framework Convention on Tobacco

Control (FCTC).

 Advertising is banned on national TV and radio.

 Law mandates that health warnings appear on tobacco packages.

 According to WHO, no materials were submitted to verify whether a national mass media

campaign ran during the survey period (up to 2016).

 National smoke-free legislation exists for public transportation.

 National smoke-free legislation does not exist for indoor offices or restaurants/cafes/pubs/

bars but designated smoke free rooms are permitted.

4 E-cigarettes regulation

and public health

measures

0 – 4 4  Safety, quality standards and regulation are in place for e-cigarettes.

 The sale of e-cigarettes is prohibited to people under 16 years of age.

 Advertising and sponsorships are prohibited for e-cigarettes with or without nicotine.

 Use of e-cigarettes is forbidden in closed public places and on public transportation (and in

all places where tobacco use is banned).

5 National policies

and programmes for

environmental exposure

control

0 – 2 3  A general EU strategy exists. The Belgian Senate has published a report on establishing a

coherent strategy and coordination between local, regional and federal levels on air quality.

 A national radon action plan was published jointly by the Ministry of Health and the

Ministry of Sustainable Development, Transport and Housing.

6 Evidence-based

approach to lung cancer

screening

0 – 1 1  Belgium is part of a key study in lung cancer screening: the NELSON study. This is a

Belgian-Dutch randomised lung cancer screening trial.

7 Patient organisations

involvement in policy

development

0 – 3 1  A specific lung cancer patient organisation has not been identified in Belgium.

 The recommendations in the Belgian clinical guidelines were reviewed by representatives

of professional associations (stakeholders including patient organisations) using a formal

procedure.

 Civil society has no opportunity to comment on HTA recommendations

Lung cancer is a race against time

8 Suspected lung cancer

patient diagnosis within

a specific time frame

0 – 2 1  Lung cancer guidelines mention conducting an urgent chest x-ray for red flag symptoms.

 Lung cancer guidelines do not mention a specific timeframe for diagnostic referral for

suspected lung cancer patients.

9 Guidelines / pathways

for rapid referral to

quality care

0 – 2 1  Lung cancer guidelines do not specifically mention rapid referral for lung cancer patients to

secondary or tertiary care.

 Lung cancer guidelines state that all treatment decisions go through a multidisciplinary

care team. Urgent referral to a lung cancer multidisciplinary team is made if the patient has

problematic symptoms severely affecting quality of life.