Unstaged lung cancer in Kentucky

Comparisons were made for unstaged lung cancer cases both to "staged" lung cancer cases and to unstaged cases from all other sites, in Kentucky for 1996-2000. Principal findings were that the likelihood of the lung cancer cases to be unstaged was greater when the cancer incidence report came from sources other than a hospital. This may implicate data system forces [for availability of necessary data for completing stage at diagnosis] rather than differences between cases per se. The risk of being unstaged by smoking status was reversed between lung cancer (lower risk) than for all other cancer sites (higher risk), an unexpected pattern. No difference for survival was found for unstaged versus staged lung cancer cases, as well as no differences for race and gender. The finding of no differences suggests that other forces (eg, age, source of payment) may contribute more greatly to one's likelihood of being unstaged with a diagnosis of lung cancer than for "all other cancer sites." These patterns pose provocative implications for how smoking status may influence clinical perspectives and those of persons faced with a diagnosis of cancer.