Poland’s society and healthcare system are grappling with a rising burden of oncological diseases, with lung cancer remaining the leading cause of cancer-related deaths for both men and women. The incidence of lung cancer is also increasing among women. What is driving this trend?
Prof. Jacek Jassem: This issue extends beyond Poland to other European countries as well. In Poland, smoking rates among men have dropped by 50% over recent decades, whereas rates among women have remained stable or even increased slightly. Tobacco companies have long marketed thin or pink cigarettes to women, emphasiszing their appeal and suggesting they were less harmful. These campaigns contributed to a rise in smoking among women, particularly younger ones, who often viewed smoking as a symbol of independence, equality, or adulthood. Changing this perception will require time and effort. Additionally, while the overall number of smokers is decreasing, the proportion of lung cancers attributable to non-smoking factors, such as air pollution, is rising. Some studies suggest that women may be at a higher risk due to hormonal factors. For instance, oestrogen, a well-known mitogen linked to breast cancer, is also thought to potentially promote lung cancer.
In September, you released the ‘Cancer Dashboard for Poland: Lung Cancer’ report. What topics did it address, and what are its key findings?
Thomas Hofmarcher: In the report, we evaluated the quality of lung cancer care in Poland by examining seven distinct aspects of the disease. We analysed various indicators for each aspect to assess patient care quality and compared it with other Visegrad Group and EU countries. We also looked at regional disparities and evaluated how Poland’s performance aligns with the objectives of the national oncology strategy and other European and global initiatives related to lung cancer. Overall, the findings indicate that Poland has yet to meet many of its targets and often falls below the EU average. Significant improvements are needed across the system. Prof. Jassem highlighted smoking as a persistent problem that must be addressed. Additionally, the report points out that poor air quality in Poland exacerbates the issue, contributing to the incidence of lung cancer.
I would like to highlightspotlight a significant finding from our report, which was made possible through our successful collaboration with the National Cancer Registry and Prof. Joanna Didkowska. For the first time, we are highlighting an encouraging trend: survival rates for lung cancer, historically very low, have begun to improve in recent years. Sadly, this improvement in Poland lags behind that observed in other countries.
Why is it so?
T.H.: Looking at diagnosis and treatment, Poland faces several challenges that complicate patients’ access to appropriate care. Recently, there has been a revolution in lung cancer treatment with the advent of new, more effective methods beyond traditional chemotherapy. Immunotherapy has largely replaced chemotherapy for most patients, and targeted therapies are being used for some. The availability of medications has improved, with the National Health Service now reimbursing new drugs, which is a positive development. However, access to these treatments is still not universal. One significant issue is the limited number of tests conducted to identify patients who could benefit from molecularly targeted therapies.
To administer such a drug effectively, it isss crucial to determine whether the patient is a suitable candidate. This requires a personaliszed approach and, importantly, the completion of specific tests. However, only about 35-40% of medical centres in Poland that treat lung cancer patients have the capability to conduct these tests promptly. Consequently, access to these diagnostics is challenging in some Voivodeships.
