The burden of lung cancer in Europe
With an estimated incidence of over 449 000 cases per year, lung cancer is one of the most common malignancies in Europe. It is particularly prevalent in Central and Eastern Europe, which shows the highest worldwide estimated age-standardized rate (53.5 per 100,000)[1].

The incidence of lung cancer is higher in men (71.94%, 323 000 cases) than in women (28.06%, 126 000 cases)[1]and non-small cell lung cancer is the most common form of the malignancy, occurring in up to 85% of cases[2].

In Europe, as well as worldwide, lung cancer is the leading cause of cancer-related deaths[3] with 353 000 deaths every year, accounting for approximately 20% of total cancer deaths[4]. Initial symptoms of lung cancer include cough, weight loss or dyspnea. These are nonspecific symptoms often attributed to benign causes, which delays the diagnosis of the condition[4]. This causes that, in most patients, lung cancer is diagnosed once it has reached an advanced stage. Late diagnosis is common, with more than 60% of patients presenting with advanced or metastatic stage IIIB/IV5.
 The consequence is an elevated death rate: seven out of eight patients diagnosed at this stage will die within five year diagnosis. Eighty percent, die within one year from being diagnosed[6].

Lung cancer treatment landscape
Over the last years, there have been progresses in surgical techniques, chemotherapy and radiotherapy, mproving the lung cancer patient treatment outcomes. And also, there have been multiple advances in our understanding of the biology and molecular mechanisms of lung cancer. Lung cancer is no longer considered a single disease, and new strategies to treat lung cancer patients have emerged in order to mprove anti-tumor activity while reducing toxic side effects for patients[5].
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Personalized medicine is quickly changing the landscape of lung cancer treatment. Currently extensive research on targeted, personalized therapies is undertaken. The goal is to incorporate molecular characterization and Next Generation Sequencing in the clinical decision making process. This requires a close collaboration between the laboratory and the clinic[7].

Key challenges in lung cancer care
Early diagnosis
Lung cancer is a curable disease if it is detected early enough. The most effective treatment is surgery[8] but this requires early diagnosis. Late diagnosis not only strongly affects survival rates, but it also has an mpact on the quality of life of patients and their caregivers. It also increases the economic costs of lung cancer management.

Avoidable delays in diagnosis occur and, for example, there is evidence that delays in referral from primary care play a part in this[9]. Three lines of action can be undertaken to ameliorate this situation. On one hand, efforts should be made to reduce the time between primary care consultation and the beginning of the treatment[10]. On the other hand, action must be taken to improve awareness and knowledge about lung cancer symptoms among the society, helping the recognition of symptoms in early stages. Finally, another key issue to avoid delayed diagnoses is improving screening and diagnosis program for people at risk.