Uncovering gaps in personalised lung cancer care in Germany: a white spot analysis.
| Title: | Uncovering gaps in personalised lung cancer care in Germany: a white spot analysis. |
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| Authors: | Berressem S; Department I of Internal Medicine, Medical Faculty, University of Cologne, University Hospital Cologne, Cologne, Germany.; Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Germany.; Moos LT; Department I of Internal Medicine, Medical Faculty, University of Cologne, University Hospital Cologne, Cologne, Germany.; Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Germany.; Röder J; VITIS Healthcare Group, Cologne, Germany.; Harzheim L; Federal Association of Outpatient Hematologists and Medical Oncologists (BNHO e. V.), Cologne, Germany.; Dreiack N; Federal Association of Outpatient Hematologists and Medical Oncologists (BNHO e. V.), Cologne, Germany.; Brodersen M; Department I of Internal Medicine, Medical Faculty, University of Cologne, University Hospital Cologne, Cologne, Germany.; National Network Genomic Medicine Lung Cancer, Cologne, Germany.; Kron F; VITIS Healthcare Group, Cologne, Germany.; Dengler R; Federal Association for Outpatient Specialist Medical Care (BV-ASV), Munich-Grünwald, Germany.; Reinhardt HC; Department of Hematology and Stem Cell Transplantation, Faculty of Medicine and University Hospital Essen, University of Duisburg-Essen, Essen, Germany.; Utzig M; German Cancer Society (DKG), Berlin, Germany.; Illmer T; Federal Association of Outpatient Hematologists and Medical Oncologists (BNHO e. V.), Cologne, Germany.; Wolf J; Department I of Internal Medicine, Medical Faculty, University of Cologne, University Hospital Cologne, Cologne, Germany.; National Network Genomic Medicine Lung Cancer, Cologne, Germany.; Kron A; Department I of Internal Medicine, Medical Faculty, University of Cologne, University Hospital Cologne, Cologne, Germany. anna.kron@uk-koeln.de.; National Network Genomic Medicine Lung Cancer, Cologne, Germany. anna.kron@uk-koeln.de. |
| Source: | BMC cancer [BMC Cancer] 2025 Dec 12; Vol. 26 (1), pp. 89. Date of Electronic Publication: 2025 Dec 12. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: BioMed Central Country of Publication: England NLM ID: 100967800 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2407 (Electronic) Linking ISSN: 14712407 NLM ISO Abbreviation: BMC Cancer Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BioMed Central, [2001- |
| MeSH Terms: | Lung Neoplasms*/therapy ; Lung Neoplasms*/epidemiology ; Lung Neoplasms*/diagnosis ; Precision Medicine*/methods ; Precision Medicine*/statistics & numerical data ; Health Services Accessibility*/statistics & numerical data ; Healthcare Disparities*/statistics & numerical data; Germany/epidemiology ; Humans ; Registries ; Female ; Male |
| Abstract: | Background: Lung cancer is among the most prevalent and deadly cancers, with around 57,000 new cases annually in Germany. Despite advances in targeted therapies, many patients still lack sufficient access to state-of-the-art comprehensive molecular diagnostics and personalised therapy throughout the disease course. This study identifies gaps in access to personalised lung cancer care in Germany. A primary objective was to analyse how many lung cancer patients are not captured by the established quality and network structures - namely, centres of the national Network Genomic Medicine (nNGM) and the lung cancer centres certified by the German Cancer Society (DKG) - to identify and ultimately close these gaps.; Methods: Publicly available data were used from inpatient quality reports, the databases of nNGM and certified lung cancer centres (DKG-LZ), the outpatient specialist medical care programme (ASV) supplemented by incidence data from the German Centre for Cancer Registry Data (2022). Differences among nNGM, DKG-LZ and ASV were assessed, focusing on non-affiliated hospitals as proxies for putative lack of quality-assured molecular diagnostic access. Geographic mapping was used to visualise regional disparities.; Results: The analysis included 993 hospitals with a total of 167,216 reimbursed lung cancer cases. 240 hospitals with 98,797 cases (59%) are affiliated with the nNGM. 108 hospitals with 78,591 cases (47%) are certified or cooperate with a DKG-LZ. ASV is provided at 152 hospitals or ASV partner hospitals (71,763 cases, 43%). nNGM and DKG jointly cover 276 hospitals and 114,472 cases (69%). Adding ASV, overall quality-affiliated coverage increases to 124,419 cases (74%). However, 668 hospitals with a total of 42,797 cases (26%) are not affiliated with any of these structures. Geographic analysis revealed regional disparities, notably in Northern Brandenburg, Lower Saxony, and Saxony-Anhalt characterised by high-incidence areas and non-affiliated hospitals managing large volumes of lung cancer cases.; Conclusions: Significant disparities in access to quality-assured molecular diagnostics persist. Expanding nNGM and integrating high-volume hospitals could raise coverage to over 85%. Standardising molecular diagnostics and quality requirements across nNGM, DKG, and ASV could further optimise access to high-quality personalised lung cancer care in Germany and build a unified real-world evidence base for equitable, consistent care.; (© 2025. The Author(s).) |
| Competing Interests: | Declarations. Ethics approval and consent to participate: Consultation with the ethics committees of the University of Cologne and the University of Duisburg-Essen has taken place. Accordingly, an ethics vote was deemed unnecessary. Likewise, no informed consent was required. Consent for publication: Not applicable. Competing interests: H.C.R. received consulting and lecture fees from Novartis, Roche, Janssen, Lilly, Takeda, Abbvie, AstraZeneca, Vertex and Merck. H.C.R. received research funding from AstraZeneca and Gilead Pharmaceuticals. H.C.R. is a co-founder of CDL Therapeutics GmbH. The remaining authors declare no competing financial interest. The remaining authors declare no competing financial interest. |
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| Contributed Indexing: | Keywords: Comprehensive molecular diagnostics; Incidence-based evaluation; Inpatient real-world data; Personalised medicine in lung cancer; Quality-assured clinical networks; White spot analysis |
| Entry Date(s): | Date Created: 20251212 Date Completed: 20260121 Latest Revision: 20260123 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12822196 |
| DOI: | 10.1186/s12885-025-15411-2 |
| PMID: | 41387799 |
| Database: | MEDLINE |
Journal Article