[Survey on the standardization of Lung Cancer Diagnosis and Treatment in Pulmonary and Critical Care Medicine in China in 2024].

Objective

To systematically evaluate the current status of clinical resource allocation and diagnostic-therapeutic capacity within the lung cancer subspecialty of the Department of Pulmonary and Critical Care Medicine (PCCM) in China.

Methods

This was a cross-sectional survey. From January to March 2024, a questionnaire survey was conducted using the stratified whole-cluster sampling method on 1 517 physicians in PCCM departments in 1 517 PCCM standardized construction units across 30 provinces in China. The 86-entry questionnaire covered five modules, including subspecialty construction, diagnosis and treatment implementation, and multidisciplinary collaboration. The data were cleaned and analysed using multiple response analysis and descriptive statistics in Excel 2021 and SPSS 26.0.

Results

A total of 1 516 physicians were included (75% from tertiary hospitals; 50.52% holding master's degrees or higher). Among them, 91.95% (1 394/1 516) expressed the willingness to manage lung cancer patients. Key findings included: 41.75% (633/1 516) of institutions had established dedicated lung cancer outpatient clinics; 50.79% (770/1 516) had specialized wards; 64% (965/1 516) operated multidisciplinary team (MDT) platforms. Tertiary hospitals retained significantly higher proportions of lung cancer inpatients than secondary hospitals (16.47% vs. 8.89%). Regional disparities were evident, with non-tertiary hospitals and institutions in central and western China showing eleficiencies in subspecialty staffing (mean: 2.84 physicians/hospital), advanced endoscopic techniques (e.g. navigational bronchoscopy coverage<30%), and targeted therapy implementation (86.28%). Primary reasons for refusal to treat were a lack of subspecialty-trained physicians (73.80%), insufficient pathological support (41.00%), and inadequate financial incentives at primary care levels (23.00%).

Conclusions

The PCCM department demonstrates high specialized in lung cancer diagnosis and treatment, and the vast majority of doctors have the ability to manage lung cancer patients. It has emerged as the primary department for initial lung cancer diagnosis, reflecting its central role in diagnosis and treatment. Although subspecialty development has enhanced diagnostic-therapeutic quality, regional resource disparities persist. Strategies such as implementing subspecialty certification programs, establishing regional pathological diagnosis centers, and improving technical support mechanisms for primary care are recommended to achieve homogeneous lung cancer care nationwide.