Article type
Abstract
"Background: Lung cancer accounted for 2.2 million new cases and 1.8 million fatalities in 2020, which made it the leading cause of cancer-related deaths (18%). The Brazilian Unified Health System (SUS) released the most recent edition of its lung cancer guidelines in 2014.
Objectives: Describe the main recommendations in the SUS guideline for the care of people with suspected or diagnosed lung cancer, as well as the procedure for updating the guideline.
Methods: Researchers, experts (i.e., pulmonologist, oncologist, radiologist), representatives of the Brazilian Ministry of Health (MoH), health professional society, and patients participated in the GRADE-based process of updating guidelines. After three meetings, participants outlined the document and the priority of technology assessments for potential coverage in SUS.
Results: Revisions to the original text included recommendations for lung cancer diagnosis, follow-up, and non-pharmacological and pharmacological treatments. There have been assessments of oesophageal (EUS)/endobronchial ultrasonography (EBUS) and PET-CT (positron emission tomography-computed tomography) for staging; reverse transcription polymerase chain reaction (rt-PCR) for detection of mutations in the epidermal growth factor receptor (EGFR); and alectinib and pembrolizumab to systemic treatment of advanced or metastatic non-small cell lung cancer. PET-CT, EBUS/EUS and rt-PCR were considered cost-effective for SUS and were favorably recommended by Conitec (National Committee for Health Technology Incorporation). The guideline is being evaluated by the MoH and will be considered by Conitec, including a public consultation, and publication.
Conclusions: The guidelines will provide recommendations for the therapeutic approach of individuals with lung cancer, improving primary and secondary healthcare while promoting the universality, comprehensiveness, and equity ideals of SUS. "
Objectives: Describe the main recommendations in the SUS guideline for the care of people with suspected or diagnosed lung cancer, as well as the procedure for updating the guideline.
Methods: Researchers, experts (i.e., pulmonologist, oncologist, radiologist), representatives of the Brazilian Ministry of Health (MoH), health professional society, and patients participated in the GRADE-based process of updating guidelines. After three meetings, participants outlined the document and the priority of technology assessments for potential coverage in SUS.
Results: Revisions to the original text included recommendations for lung cancer diagnosis, follow-up, and non-pharmacological and pharmacological treatments. There have been assessments of oesophageal (EUS)/endobronchial ultrasonography (EBUS) and PET-CT (positron emission tomography-computed tomography) for staging; reverse transcription polymerase chain reaction (rt-PCR) for detection of mutations in the epidermal growth factor receptor (EGFR); and alectinib and pembrolizumab to systemic treatment of advanced or metastatic non-small cell lung cancer. PET-CT, EBUS/EUS and rt-PCR were considered cost-effective for SUS and were favorably recommended by Conitec (National Committee for Health Technology Incorporation). The guideline is being evaluated by the MoH and will be considered by Conitec, including a public consultation, and publication.
Conclusions: The guidelines will provide recommendations for the therapeutic approach of individuals with lung cancer, improving primary and secondary healthcare while promoting the universality, comprehensiveness, and equity ideals of SUS. "