Objective: The Hungarian Undiagnosed Lung Cancer (HULC) study aimed to explore the
potential reasons for missed LC (lung cancer) diagnosis by comparing healthcare and
socio-economic data among patients with post-mortem diagnosed LC with those who were
diagnosed with LC during their lives.
Methods: This nationwide, retrospective study used the databases of the Hungarian
Central Statistical Office (HCSO) and National Health Insurance Fund (NHIF) to identify
patients who died between January 1, 2019 and December 31, 2019 and were diagnosed
with lung cancer post-mortem (population A) or during their lifetime (population B).
Patient characteristics, socio-economic factors, and healthcare resource utilization
(HCRU) data were compared between the diagnosed and undiagnosed patient population.
Results: During the study period, 8,435 patients were identified from the HCSO database
with LC as the cause of death, of whom 1,203 (14.24%) had no LC-related ICD (International
Classification of Diseases) code records in the NHIF database during their lives (post-mortem
diagnosed LC population). Post-mortem diagnosed LC patients were significantly older
than patients diagnosed while still alive (mean age 71.20 vs. 68.69 years, p<0.001),
with a more pronounced age difference among female patients (difference: 4.57 years,
p<0.001), and had significantly fewer GP (General Practitioner) and specialist visits,
X-ray and CT scans within 7 to 24 months and 6 months before death, although the differences
in GP and specialist visits within 7–24 months did not seem clinically relevant. Patients
diagnosed with LC while still alive were more likely to be married (47.62% vs. 33.49%),
had higher educational attainment, and had more children, than patients diagnosed
with LC post-mortem.
Conclusions: Post-mortem diagnosed lung cancer accounts for 14.24% of total lung cancer
mortality in Hungary. This study provides valuable insights into patient characteristics,
socio-economic factors, and HCRU data potentially associated with a high risk of lung
cancer misdiagnosis.
