Background and objective. A population-based Cancer Registry has monitored cancer burden in Finland since 1953. However, for a long time the need for a Cancer Care Quality Register has been evident. A quality register research project was launched in 2023 together with the Finnish Institute of Health and Welfare, the Cancer Society of Finland/Finnish Cancer Registry and Finnish Cancer Center FICAN to monitor cancer treatment in the whole country. The project aims to utilize the mandatory national reporting for cancers (the Finnish Cancer Registry), other health registers and other hospital-based data sources to compile individual patient pathways. 
Methods. Lung cancer was chosen as the first pilot cancer, due to lower patient survival in Finland compared to other Nordic countries. The first report was published in November 2024. The report is based on incident primary lung cancer cases (ICD-10 codes C33–C34) diagnosed between 1 January 2018 and 30 June 2022, totaling 13,324 new cases. Date and type of treatment for each patient was obtained from the Care Register for Health Care.
Results. During the first six months after diagnosis, nearly one third of patients died. Only about one in ten patients (N = 1627) were treated with surgery, just under one third (N = 3660) received radiotherapy, and slightly more than one fifth (N = 2884) received medical/drug treatment within the first six months after diagnosis. Approximately one half of the patients had no lung cancer treatment procedures registered within the first six months. During the same time period, nearly one third of patients died with no prior treatment.
Most lung cancer patients were elderly: about two thirds were 70 years of age or older at the time of diagnosis. There were no significant differences in the distribution of age at diagnosis between the collaborative areas, but the histological type of cancer differed statistically significantly between areas for both men and women (p-values < 0.001). Notably, there were clear regional differences in the proportion of cancers with no histological subtype (so-called clinical cancers). These cancers were statistically significantly more common in Northern and Eastern Finland (28% and 26%) than in other regions, while in Western Finland their proportion was clearly lower (15%). 
Implications. Our findings implicate challenges in the diagnosis phase of patient path in northern and eastern regions with long distances and low population density.

Histological subtypes of Lung Cancer Patients in Finland by collaborative welfare area