Opportunities for Improvement
Recommendation
Belgium needs an updated National Cancer Control Plan.
Rationale
Indicators 1: Belgium’s National Cancer Control Plan was published in 2008 and needs to be updated. An updated national
cancer control plan should ideally include the following elements—which were only weakly covered at best in the current
plan: discussion of prevention, screening and early detection, red flags and symptoms to look for in primary care, diagnosis, an
implementation plan and a funding source. A specific lung cancer control plan has not been published by the government or
health ministry.Recommendation
Referral for diagnostic assessment for patients suspected of having lung cancer should be prioritised within a specified time
period as there is currently no mention of rapid referral for diagnostic testing.
Rationale
Indicators 8 & 9: Providing a timeframe within which patients suspected of having lung cancer should receive testing is an
important milestone for delivery of care as well as having a timeframe for confirmed lung cancer patients to receive secondary or
tertiary care. Belgium does not provide such timeframes, nor does it have dedicated fast track referral processes in its lung cancer
guidelines. Workshop participants emphasised the importance of timing at every stage of the journey and stressed that a referral
pathway needed to specify the workup involved for diagnosis. Participants felt that creating networks between smaller and larger
hospital centres could be helpful and that thought could be given to centralising care.Recommendation
Ensure that multidisciplinary care teams include a patient’s primary care physician in their discussions.
Rationale
Indicator 9: Belgium’s lung cancer clinical guidelines state that all treatment decisions are reviewed by a multidisciplinary care
team. Workshop participants felt that it is important to include the primary care physician in the multidisciplinary care team.
While geographical distance may make it challenging to include the primary care physician, it is important that they are seen as
part of the team and kept informed of the decisions that are being made. This can ensure that primary care physicians are better
informed about the care received and are able to manage their patient’s care when the patient returns home.Recommendation
The use of molecular testing for lung cancer patients is recommended for patients with advanced or recurring disease and
should be reimbursed.
Rationale
Indicator 12: Workshop participants emphasised the importance of reimbursement for biomarker testing. While the Belgian lung
cancer clinical guidelines recommend the use of histology and molecular testing in patients with advanced or recurring disease,
only one of the tests is currently reimbursed.Opportunity 1
Opportunity 2
Opportunity 3
Opportunity 4