For health professionals

Screening algorithm

Algoritmus screeningového procesu

* In specific cases, direct referral of persons meeting the inclusion criteria by a general practitioner to the radiology centre is possible

** Patients with a LDCT (low-dose CT) result contact their pulmonologist, who arranges either further investigation or referral to a cancer centre or a pneumo-oncology centre

Lung cancer epidemiology in the Czech Republic

The main source of data on cancer epidemiology is the National Cancer Registry of the Czech Republic (CNCR). Today, NOR is an integral part of comprehensive cancer care and with 100% coverage of the Czech population, it contains more than 2.6 million records for the period 1977–2018. Registration of neoplasms is stipulated by law and mandatory. These data are available to the general public on the website www.svod.cz.

Incidence and mortality of lung cancer

Lung cancer is one of the most common cancer diagnoses in the Czech Republic and the most common cause of death among cancer diagnoses (Figure 1).

ZN plic (C33, C34) – vývoj incidence a mortality

Figure 1: Number of deaths from neoplasms per year, average numbers from 2014–2018 (Data source: CZSO)

The mortality rate (i.e. the number of deaths from a given disease) of lung cancer is very similar to the incidence rate in the long term (Figure 2). Around 6 500 patients are newly diagnosed with this cancer in the Czech Republic each year and approximately 5 500 patients die from it. Males have a higher incidence and mortality rate of lung cancer than females (Figure 3), but while a decrease in both incidence (-10.3% between 2008 and 2018) and mortality (-11.3%) can be observed in males, both incidence (+29.2%) and mortality (+24.3%) have been increasing in females.

ZN plic (C33, C34) – vývoj incidence a mortality

Figure 2: Lung cancer (C33, C34) – incidence and mortality (Source: CNCR)

ZN plic (C33, C34) – vývoj incidence a mortality dle pohlaví

Figure 3: Lung cancer (C33, C34) – incidence and mortality according to sex (Source: CNCR)

Prevalence of lung cancer

In the last ten years, there have been signs of improvement in the epidemiological situation, especially a stabilisation or even a decrease in mortality, but with the ever-increasing incidence. The inevitable consequence is an increase in prevalence, i.e. the number of living people who have been diagnosed and treated for lung cancer in the past. In 2018, the prevalence rate was 12 322, an increase of more than 31% compared to 2008 (9 371) (Figure 4); for men it was 10% and for women 78%.

ZN plic (C33, C34) – vývoj prevalence

Figure 4: Lung cancer (C33, C34) – prevalence (Source: CNCR)

Clinical stages at diagnosis

It is well known that detecting cancer at a less advanced clinical stage significantly increases the chances of a good treatment outcome and long-term survival. Unfortunately, available population-based data on lung cancer show that a very high proportion (more than 70%) of new lung cancer patients in the Czech Republic are still diagnosed at clinical stage III or IV (Figure 5). This is a very negative fact, also with respect to the 5-year relative survival of patients treated for lung cancer, which is approximately 13% for stage III and even only about 3% for stage IV. In contrast, the 5-year survival for stage I is almost 65%, and thus improving early detection may have a significant positive impact on lung cancer mortality in the Czech population.

ZN plic (C33, C34) – vývoj zastoupení stadií

Figure 5: Lung cancer(C33, C34) — proportion of clinical stages (Source: CNCR)

Patients' age

The typical age of a Czech lung cancer patient is 63–75 years and the average age at diagnosis is 69 years (Figure 6). Thus, a quarter of patients are diagnosed at a productive age. Figure 7 shows the age-specific incidence profile of lung cancer.

ZN plic (C33, C34) – věková struktura pacientů

Figure 6: Lung cancer (C33, C34) – age structure, period 2014–2018 (Source: CNCR)

ZN plic (C33, C34) – věkově specifická incidence

Figure 7: Lung cancer (C33, C34) – age-specific incidence, period 2014–2018 (Source: CNCR)