Clinico-pathological characteristics and treatment outcome in non-small cell lung cancer in Greenland 2015-2020 - a comparison with the cohort from 2004 to 2010.

Background and purpose: Lung cancer is the leading cause of cancer-related mortality in Greenland. Since 2004, medical treatment of lung cancer has been available in Greenland. However, both diagnostic work-up and treatment logistics are hampered by the lack of medical services in smaller settlements, the infrastructure, and extreme arctic weather conditions. Clinico-pathological data and assessment of treatment outcome in lung cancer in Greenland have not been carried out since 2015. This study aims to provide an analysis of Greenlandic patients with non-small cell lung cancer (NSCLC) from 2015 to 2020, compared to the cohort from the 2015 study. We focus on diagnostics, patient and treatment characteristics, and survival rates. Additionally, we include new data on treatment-related factors and diagnostic delays. Patients/material: Clinical-, pathological-, genomic data, tuberculosis status and survival were retrieved from the medical journal.

Results: A total of 163 patients were identified. Survival had improved in stage I, III, and IV, and early-stage disease was more often diagnosed as compared to the 2015 cohort. Molecular alterations and PD-L1 expressing tumors were comparable between Greenlandic and Danish patients. Diagnostic delay was a major concern.

Interpretation: While NSCLC survival in Greenland has improved over the past decade, significant challenges remain. The trend towards diagnosing more stage IA-IIIA patients and the recent improvements in diagnostic and therapeutic options in Greenland are expected to translate into a better prognosis in the coming years. Addressing diagnostic delays and enhancing treatment options are crucial steps toward improving outcomes for NSCLC patients in Greenland.