Recommendations for the development of an integrated lung cancer care process: an expert consensus report

To identify key aspects of the lung cancer care process and generate prioritised recommendations to optimise coordination, quality, and equitable access to diagnosis and treatment.

24 experts from the National Advisory Committee of the Lung Ambition Alliance in Spain participated in a structured consensus process using an adapted RAND/UCLA method. The process comprised three phases: literature review (Phase I), identification of key issues (Phase II, n = 21), and prioritisation of recommendations (Phase III, n = 24). Each recommendation was scored for impact and feasibility on a 1-9 Likert scale. Agreement was defined when ≥ 66.6% of experts rated within the same range as the median; disagreement when ≥ 33.3% scored in both the 1-3 and 7-9 ranges; other cases were considered indeterminate.

A total of 76 recommendations addressing 34 key aspects were identified (66% related to humanisation and perceived care quality and 34% to coordination and continuity). From which, 62 achieved agreement for impact and 14 were indeterminate; regarding feasibility, 10 reached agreement, 2 met disagreement criteria and 64 were indeterminate. In this regard, 17 high-priority recommendations (high impact and feasibility) were prioritised, covering prevention, access to diagnosis and treatment, standardisation of care processes and communication with patients. In addition, 29 recommendations were classified as high impact, relating to information systems, care coordination, prevention and awareness, equity in access to diagnostic tests and treatment, and patient care and safety.

Implementing these recommendations is essential to enhance equity, coordination, and quality of lung cancer care, requiring a nationwide, multi-stakeholder effort to advance towards an integrated and patient-centred model.