Clinical spectrum of lung cancer across hospitals under the National Cancer Registry Programme in India: Challenges and opportunities.

Background and objective: Lung cancer is one among the top five cancers in India, both in incidence and mortality and is thus, a significant public health challenge. The economic disparities among nations significantly contribute to differences observed in the management of lung cancer.

Methods: This study analysed the clinical spectrum of lung cancer from several hospitals using data from the National Cancer Registry Programme concerning demographic characteristics of patients, histological variants, and diagnostic and management practices between 2012 and 2019. For this descriptive study, data was drawn from 96 Hospital-Based Cancer Registries. Altogether, all cases classified under ICD-10, C34.90 were included in this study.

Results: The study findings revealed that most lung cancer cases occurred in males aged 50-74 years and females aged 45-69 years. Adenocarcinoma were the most common (39.7%) variety, almost twice higher than squamous cell carcinoma subtypes. The majority (50.7%) of the patients with lung cancer were detected with distant metastases. Low rates of surgery were observed among the patients who had localised/locoregional spread, while one third of the patients diagnosed at another facility reported to the treating hospital between 7 to 30 days after diagnosis.

Conclusion: This study highlights that delay in referral and subsequent treatment initiation are critical challenges in lung cancer care, including delayed diagnosis, limited treatment options, and a lack of streamlined referral processes. The study findings will be crucial for identifying the gaps in care and guiding strategies to improve early diagnosis and treatment of lung cancer.