Small Cell Lung Cancer in Norway: Patterns of Care by Health Region and Survival Trends

Introduction/Background: There has been a marked survival improvement for patients with non-small cell lung cancer. We describe the national trends in characteristics and survival, and geographical differences in diagnostic workup, treatment, and survival for patients with small cell lung cancer.Materials and Methods: Patients registered with small cell lung cancer at the Cancer Registry of Norway in 2002–2022 were included. Trends in overall survival were estimated for all small cell lung cancer patients, patients with limited stage small cell lung cancer, patients undergoing surgery, and by health region. Adjusting for case-mix, a multivariable Cox regression was performed examining the association between health region and death.Results: The study included 8 374 patients. The stage distribution remained unchanged during the study period. The 5-year overall survival increased from 7.7% to 22.8% for patients with limited stage. The use of multidisciplinary team meetings varied from 62.5% to 85.7%, and the use of positron-emission tomography computer-tomography varied from 70.4% to 86.2% between the health regions. Treatment patterns differed markedly between the health regions, with the proportion dying without any registered treatment ranging from 1.2% to 10.9%. For limited stage patients in 2018–2022, the median overall survival ranged from 16.5 to 25.5 months across health regions, and the 5-year overall survival ranged from 18.7% to 28.7% (p=0.019).Conclusion: The survival for patients with small cell lung cancer remains poor. The use of diagnostic procedures, treatment modalities, and survival differed between regions, warranting investigations to further explore the reasons.MicroAbstractPatients with small cell lung cancer (SCLC) seem to have missed the survival improvement as other histological subtypes.Based on national data, trends on diagnostics, treatment, survival, and regional disparities for SCLC have been studied.The survival is still poor but subgroups as those resected had improved survival, and there were marked differences between the national regions.