Steadily improving survival in lung cancer

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• Lung cancer survival rates have shown minimal improvement nationally over the past 30 years.
• Significant advances in lung cancer treatment have not translated into widespread survival gains.
• There is a need to analyze temporal trends in lung cancer patient demographics, staging, therapy, and survival.

Purpose of the Study:

• To investigate changes in demographic characteristics, disease stage, treatment, and survival over time for lung cancer patients.
• To compare local trends in lung cancer outcomes with national data.
• To identify factors contributing to observed survival improvements in a community hospital setting.

Main Methods:

• Retrospective analysis of clinical features and survival data for lung cancer patients.
• Data collected from a large community hospital cancer registry in southern California.
• Patients were grouped into four successive 6-year diagnostic eras from 1986 to 2009.

Main Results:

• Median survival improved from 11 to 26 months, and 5-year survival increased from 16.5% to 31.1% over the study period.
• The proportion of patients diagnosed with localized lung cancer rose from 18.4% to 31.6%.
• Significant shifts in histology were observed, including an increase in adenocarcinoma and neuroendocrine tumors, and decreases in squamous cell and small cell carcinomas. Chemotherapy use for localized disease tripled.

Conclusions:

• Lung cancer survival has steadily improved for patients in this community.
• Earlier diagnosis, a decrease in smoking-associated histologic types, and increased use of systemic therapies are key factors contributing to improved survival.
• Local improvements in lung cancer survival significantly outpaced national trends.