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Indicator Range Score Justification

Lung cancer is at a crossroads
10 Medical and surgical
specialists

Number

per 100,000

unscored  In 2014:
3.68 pulmonologists
2.00 thoracic surgeons
8.65 general surgeons
3.2 oncologists.^8
11 Radiotherapy
accessibility

Number of

MVM; % unmet

need

unscored  -6 = difference between supply and demand of radiotherapy megavoltage machines
(MVM). (minus sign = deficit)
 Percent of unmet need between observed and expected number of radiotherapy
megavoltage machines is -11.8%.
 No data available to assess the length of time a lung cancer patient must wait in order to
access radiotherapy treatment.
12 Tumour testing
recommendations and
accessibility

0 – 6 5  Histological and molecular testing are mentioned in the diagnostic guidelines for lung
cancer and specific biomarkers are identified.
 EGFR, ALK and PD-L1 tests are reimbursed under national public health system.
 ROS1 is not approved and not reimbursed.
13 Key personalised
medicines
reimbursement and
accessibility

0 – 10 10  All five of the tyrosine kinase inhibitors and anti PD1 antibodies studied are registered and

available for the majority of patients through the health system.

14 Understanding
psychological burden of
lung cancer and access
to support services

0 – 2 1  Lung cancer guidelines include psychological assessment and mention the psychological

burden of lung cancer.

 Guidelines do not present a referral pathway to psychological support services.

15 Patient access to
supportive / palliative
care services

0 – 2 2  Lung cancer guidelines view palliative care services as an important component of care
and endorse early integration of palliative care services.
 Finland has adopted the ESMO curriculum in their clinical oncology training programme.
ESMO curriculum includes many competencies on supportive measures, palliative care
and end of life care.
Lung cancer is a focus for research
16 Clinical and outcomes
data collection

0 – 7 7  High quality population-based cancer registry (PBCR) (national)
(3 points out of a possible 3).^9
 High quality complete vital registration (4 points out of a possible 4).^9
17 Research support and
funding

R&D as % of

GDP; ratio of

clinical trials

unscored  2.75% of GDP spent on research and development in 2016.

 Number of clinical trials between 2009-2018 = 52.^10

 The ratio of 2009-2018 clinical trials to GDP (billions) = 0.206.^11