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M.I. Patel



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    O24 - Cancer Control and Epidemiology III (ID 134)

    • Event: WCLC 2013
    • Type: Oral Abstract Session
    • Track: Prevention & Epidemiology
    • Presentations: 1
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      O24.03 - Lung cancer incidence trends among Asian-American ethnic populations in the United States, 1990-2010 (ID 1969)

      16:35 - 16:45  |  Author(s): M.I. Patel

      • Abstract
      • Presentation
      • Slides

      Background
      In the United States (US), anti-smoking policies have resulted in a population-wide decline in lung cancer rates over the past decade. However, little is known about how lung cancer incidence trends vary among Asian-American ethnic populations, the largest growing population in the US.

      Methods
      For the first time, annual population estimates for Asian-American ethnic populations were developed for the regions in the Surveillance, Epidemiology, and End Results program, comprising half of the total U.S. Asian-American population. From 1990-2010, incidence rates and average annual percentage change (APC) were computed for each racial/ethnic group for lung cancer overall and by gender and histology.

      Results
      Among Asian-American males, trends were either stable or declining in all groups (Figure 1). The declines were statistically significant among Koreans (APC = -3.0), Hawaiians (APC = -2.3), Vietnamese (APC = -1.4), Filipino (APC = -1.9 from 1996-2010), and Chinese (APC = -1.5). Among Asian-American females, declining trends were seen among Hawaiians (APC = -5.9 from 2002-2010) and Vietnamese (APC = -1.5). In contrast, increasing trends were seen among Japanese (APC = 1.7) and Filipinas (APC = 1.5). Among Asian-American males, all histologies exhibited stable or declining trends with the exception adenocarcinoma, which increased among Chinese males from 1997-2010, appearing independent of the decrease in NOS, which occurred much later in this group. Among Asian-American females, declining or stable trends were seen for most histologies, with the exception of adenocarcinoma among Filipina and Korean females (APC = 2.5 and 3.0, respectively), and squamous cell carcinoma among Japanese females (APC = 2.4). Figure 1

      Conclusion
      To the extent that Asian-Americans have distinct primary and second-hand smoking profiles, unique environmental exposures , and population-specific genetic predisposition, analysis of incidence trends by histology suggests that, among Asian-American females, additional risk factors beyond primary and perhaps secondary smoking may be important for lung cancer etiology. The continued increase of lung cancer incidence among Filipina, Korean, and Japanese American females, especially in adenocarcinomas and squamous cell carcinomas, warrants further attention.

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    P1.24 - Poster Session 1 - Clinical Care (ID 146)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P1.24-008 - Are patients' needs being met after-hours? An evaluation of phone calls made after hours for patients with thoracic malignancies. (ID 873)

      09:30 - 09:30  |  Author(s): M.I. Patel

      • Abstract

      Background
      Understanding phone calls that patients with lung cancer make after hours is important as it represents an opportunity to provide improved care for patients and their caregivers. Furthermore, better understanding of after- hours phone calls can help to influence ways to reduce healthcare spending. Therefore, we sought to evaluate the nature of after-hours calls initiated by patients and their caregivers to the thoracic oncology clinic from the hours of 5pm-8am and on weekends.

      Methods
      The study is a retrospective analysis of 4 months of outpatient phone calls made to the Stanford Cancer Institute during the weekends and hours of 5pm until 8am on weekdays. On-call after-hours physicians documented who made the call, chief complaint, age, gender and the advice given. Phone calls were excluded from analysis if there was missing information regarding reason for call or advice given. Differences in proportions were analyzed by Fisher's exact test. A two-sided p value <0.05 was considered significant.

      Results
      There were a total of 271 phone calls made after hours by patients with lung cancer, however after exclusions, there were 215 phone calls for analysis. The majority of phone calls occurred between the hours of 5pm and 11pm (n = 157; 73%) followed by daytime calls made during the weekend (n = 37; 17%). A majority of the phone calls were made by the patient (50%) with a slightly lower proportion made by a family member (46%). The majority of the patients who called were in their 50’s (29%) and female (54%). A high proportion of patients called for more than one chief complaint (30%) although almost all patients complained of more than one symptom on review of systems (95%). The main symptoms patients called for were cough (28%) followed by shortness of breath (27%). Of the phone calls made, 62% (133) were referred to the emergency room. Of those patients referred to the emergency department, 77% (103/133) resulted in a hospital admission.

      Conclusion
      Most after-hours phone calls from patients with lung cancer are related to symptoms. A large proportion of patients who were referred to the emergency department subsequently required an admission. Future studies should evaluate whether there are ways to improve patient triage after hours and improve symptom control to prevent hospitalizations for these patient populations.

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    P3.22 - Poster Session 3 - Epidemiology, Etiology (ID 168)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Prevention & Epidemiology
    • Presentations: 1
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      P3.22-008 - Are there disparities in lung cancer incidence trends among Hispanics and African Americans? An analysis of the Surveillance Epidemiology and End Results Database 1992-2010 (ID 3049)

      09:30 - 09:30  |  Author(s): M.I. Patel

      • Abstract

      Background
      Previous studies demonstrate disparities in the incidence of lung cancer. Specifically, in the United States, in comparison to non-Hispanic Whites, African Americans have a higher incidence rate of lung cancer while a lower incidence rate is seen among Hispanics. Recent studies demonstrate significant progress in smoking-cessation programs for non-Hispanic Whites; however, there are still a lower number of smoking cessation programs directed towards African Americans and trends of increased smoking behavior among Hispanics. No studies have evaluated recent histologic-specific incidence trends of lung cancer that may reflect these changing smoking behavioral patterns.

      Methods
      Using the Surveillance, Epidemiology and End Results data from years 1992-2010, lung cancer incidence rates and average annual percentage change (APC) were computed overall and by histology for African Americans, Hispanics, and non-Hispanic Whites.

      Results
      Incidence rates of lung cancer steadily decreased for non-Hispanic Whites, African-Americans, and Hispanics males (APC = -2.0, -2.6, and -1.9, respectively) from 1992 to 2010. This was true for all histological subtypes. Overall incidence rates of lung cancer among females have been relatively stable, with evidence of recent declines since 2005 among African Americans and non-Hispanic Whites. These trends were seen for all histological subtypes among females, except for the notable exceptions of increases in adenocarcinoma among African Americans (APC = 2.9 from 2003-2010) and Hispanics (APC = 1.2 from 1992-2010).

      Conclusion
      For men, overall and histologic-specific incidence rates of lung cancer have decreased among Non-Hispanics Whites, African Americans, and Hispanics. For women, in recent years, non-Hispanic Whites demonstrate a similar pattern of decline in lung cancer incidence rates. However, the overall incidence rate of lung cancer among African American and Hispanic women while decreasing or remaining slightly stable, an increased incidence of adenocarcinoma has been observed that warrants further exploration.