OBJECTIVES: The SCAN-LEAF project aims to describe the epidemiology, clinical care and outcomes of NSCLC in Scandinavia. Here, we report real-world HCRU for NSCLC patients in Sweden.

METHODS: This retrospective cohort study includes all adult patients diagnosed with NSCLC from 2012–2015 in Uppsala and Stockholm University hospitals and without any concomitant cancer (follow-up until end of 2016). Electronic medical records were extracted and linked with national registries. HCRU included hospitalisations, outpatient visits, imaging, tissue sampling, biomarker tests, lung surgery, radiotherapy and systemic anti-cancer therapy (SACT) from diagnosis date. Analyses included HCRU within 12 months of diagnosis (per patient) and over entire follow-up period (aggregate annualised rate), by stage and histology. Aggregate rate of HCRU per patient-years was calculated as total number of visits /total patient-years of follow-up.

RESULTS: Among 2779 incident NSCLC cases, 1095 (39.4%) were Stage I-IIIA and 1625 (58.5%) Stage IIIB-IV. Mean age was 69.5 years. Mean follow-up was 2.2 years for Stage I-IIIA and 0.9 years for Stage IIIB-IV. Among Stage I-IIIA and IIIB-IV cases respectively, 39.5% and 1.0% had undergone surgery; 54.5% and 51.6% received radiotherapy; 35.1% and 57.2% had ≥1 SACT regimen; and 37.4% and 45.7% had ≥1 biomarker test. Rate of hospitalised days per patient-year was 11.1 (95%CI[11.0-11.3]) for Stage I-IIIA and 30.8 (95%CI[30.5-31.1]) for IIIB-IV (median [Q1-Q3] within 12 months: 9[2-18] and 16[5-32], respectively). The rate of outpatient visits was 10.3 (95%CI[10.2-10.4]) and 16.0 (95%CI[15.8-16.2]) per patient-year, and of imaging tests was 1.4 (95%CI[1.4-1.5]) and 2.6 (95% CI[2.5-2.7]) per patient-year, respectively.

CONCLUSIONS: These real-world HCRU data demonstrate the substantial healthcare burden associated with management of advanced NSCLC (stage IIIB-IV): more than 30 days of hospitalisation and 16 outpatient visits per patient-year. A high proportion of IIIB-IV patients remained untreated (no SACT). Ongoing analyses will add understanding of HCRU by line of therapy.