Prevalence of lung cancer morbidity among the population of the Moscow region: organizational and epidemiological rationale for a regional model of early detection and patient pathway management

The persistently high proportion of late-stage lung cancer is the basis not only for assessing the relevant indicators, but also for organizing the diagnostic route. Objective. To perform an organizational and epidemiological analysis of lung cancer in the Moscow region and to substantiate the need for a regional model for early detection and patient routing, with subsequent assessment of its efficacy at different stages. Materials and methods. A retrospective, descriptive, organizational and epidemiological study was carried out using data from the Federal Statistical Digests for 2014—2024, Federal Statistical Observation Form № 7 for the Moscow region for 2023—2025, and Form № 30 for the Regional Endoscopy Service for 2023—2025. Incidence, active detection, morphological verification, staging, radical treatment, and bronchoscopic diagnostic parameters were assessed. The efficacy of the proposed model as an implementation technology was not evaluated in this study. Results. In the Russian Federation, the proportion of morphologically confirmed cases of trachea, bronchus, and lung cancer increased from 70.7% in 2014 to 90.9% in 2024. The proportion of stage IV cases in 2024 was 43.0%, and the one-year mortality rate was 44.3%. In the Moscow region, the proportion of morphologically verified diagnoses increased from 87.2% to 94.3% between 2023 and 2025, while the proportion of stage III—IV disease remained high: 60.5%, 57.2%, and 56.7%, respectively. Diagnostic bronchoscopy accounted for less than 5% of all diagnostic endoscopic examinations. The data highlight the necessity to integrate the morphological verification stage, including bronchoscopic diagnosis when indicated, into a managed regional route from the initial detection of suspicious changes to definitive confirmation and treatment initiation. Conclusions. The high proportion of late-stage disease with a high level of morphological verification serves as a rationale for developing a regional routing model with an expert-based, refined diagnostic stage, the efficacy of which should be assessed using stage-specific organizational and clinical indicators.