Development and status of medical oncology in China (De-SMOG): A nationwide questionnaire-based survey.

Abstract

e23119 Background: The growing cancer burden in China necessitates ongoing enhancements in cancer management. Medical oncology is a pivotal component of comprehensive cancer care since its recognition as an independent specialty. This study is aimed to delineate status of medical oncology in China. Methods: A questionnaire encompassing general information and dimensions representing status of medical oncology namely infrastructure, medical service, quality of care, and clinical research was sent to the medical oncologists working in 167 tertiary hospitals across 30 provinces in China, including 147 general hospitals and 20 specialized oncology hospitals. Participants completed the survey with the aid of a trained coordinator to ensure the quality of the results. Results: A total of 167 oncologists completed the survey. Over 80% of hospitals have established a cancer center comprising medical oncology and other specialties. The average number of hospital beds for medical oncology department is 84, with a length of stay averaging at 3.8 days per patient. In 2023, average number of outpatient visits to medical oncology department was 14.4 thousand. Most hospitals (92.0%) have a day-care unit for medical oncology and 73.2% of them with an average number of patient visits over 100 per month. Multidisciplinary teams (MDT) for specific tumors have been established in most hospitals (94.4%). However, MDT evaluation rate for patients prior to treatment stands at 16.2%, which is higher in oncology hospitals (25.6%) compared to general hospitals (14.8%). Before initiating medical treatment, rates of pathological diagnosis, TNM staging, and molecular test are 79.7%, 81.3%, and 74.6%, respectively, and are also higher in oncology hospitals (88.0%, 91.5%, and 84.4%). Almost all participants (96.3%) report that the interval between pathological diagnosis and the initiation of medical treatment for their patients can be controlled within 2 weeks or less. Prescription review of oncology drugs has been performed in most hospitals (98.1%). All surveyed hospitals can conduct clinical trials for oncology drugs, with an average of 165 registered trials conducted between 2021 and 2023. However, hospitals situated in third-tier cities exhibit a much lower count of registered trials (23 vs. 165), and more than half of these hospitals (56.9%) cannot carry out phase I trials. Conclusions: China's medical oncology experienced rapid development in last decade. While providing efficient services to cancer patients, it promotes the standardized treatment and the development of innovative drugs in China. Nevertheless, its development in China is still uneven, highlighting the demand of support for research in underdeveloped areas.