Burden of lung cancer and application of patient-reported outcomes in the Western Pacific Region: a systematic analysis

Background: The burden of lung cancer and the experiences of patients necessitate attention. This study evaluated the disease burden of lung cancer and the attributes of patient-reported outcomes (PROs) in clinical trials pertaining to lung cancer within the Western Pacific Region (WPRO). Methods: Drawing upon data from the Global Burden of Disease Study (GBD) 2021, the incidence, mortality, and disability-adjusted life years in the WPRO from 1990 to 2021 was retrieved and analyzed. Clinical trial data conducted within the WPRO spanning from 2010 to 2022 were extracted from International Clinical Trials Registry Platform, encompassing trial phases, study settings, participant demographics, and PRO instruments. Trials were categorized into three groups based on the mention of PRO usage and the utilization of specified PRO instruments. Results: In 2021, the WPRO witnessed 1.15 million (95% UI 0.96-1.36) new lung cancer cases and 0.99 million (95% UI 0.82-1.16) deaths. From 1990 to 2021, Singapore showed the most pronounced decline in the age standardized incidence (-38.62, 95% UI -46.63 to -30.99), while China was experiencing the highest increase (32.92, 95% UI 1.21-71.31). Among the 3,889 trials examined, 24.48% trials employed PRO instruments as outcome measures. A majority of these PRO-related trials were conducted in China, Japan, Australia and South Korea, with frequently used PRO instruments including the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires-Lung Cancer 13, and the Visual Analogue Scale. Conclusion: Marked disparities existed in the lung cancer burden among the individual countries in the WPRO. There is a pressing need to allocate further resources toward the implementation of standardized, condition-specific PROs and strategies aimed at minimizing the lung cancer burden, especially in low and low-middle SDI countries.