Closing the gap in lung cancer care disparities through innovation
Lung cancer remains a major global health challenge despite significant advances in detection and treatment. In low- to middle-income countries (LMICs) like Indonesia, where smoking rates are high and healthcare resources are limited, this burden is even greater. Indonesia, with 17,000 islands, faces enormous challenges in delivering equitable access to lung cancer care. Meanwhile, treatment and early detection have significantly evolved, with innovations such as low-dose CT (LDCT) screening, artificial intelligence (AI), and electronic nose (eNose). Yet this progress raises a critical question: are these innovations reaching the patients who need them most?
This thesis begins by examining experiences from five university hospitals in Indonesia to understand the barriers patients encounter. It shows that unequal distribution of health infrastructure and medical expertise is a primary driver of the disparities. We then evaluated access to targeted therapy and found that many eligible patients still do not receive optimal care. This thesis also reviews advances in the management of stage III lung cancer, a complex stage requiring multidisciplinary approaches that are often difficult to achieve in resource-limited settings. Finally, this work evaluates LDCT screening alongside complementary technologies such as AI and eNose, which show promise in improving early detection and supporting clinical decision-making.
Technological innovation alone, however, is not sufficient. Improving lung cancer outcomes requires equitable access to diagnosis, treatment, and infrastructure. The true value of innovation lies not in progress itself, but in ensuring its benefits reach every patient. How these promising innovations can close this gap remains the critical challenge.