Author of

• 11929

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  P2.22 - Poster Session 2 - Epidemiology, Etiology (ID 167)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Prevention & Epidemiology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11933

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    P2.22-004 - Survival improvement in primary lung cancer patients in a 10-year period: results of the French KBP-2000-CPHG and KBP-2010-CPHG cohorts (ID 1361)

    09:30 - 09:30  |  Author(s): S. Jeandeau
    • Abstract

    Background
    Due to its high incidence and bad prognosis, lung cancer is a major health problem. In the 2000s, several social and scientific changes (such as decreased smoking, improved diagnosis methods, or the development of new drugs and therapeutic strategies) may have changed the epidemiology and prognosis of this cancer. The objective of the present study was to compare 1-year mortality in adult patients with primary lung cancer at a 10-year interval.

    Methods
    In 2000 and 2010, the French College of General Hospital Respiratory Physicians (CPHG) performed 2 prospective multicenter cohort studies collecting information on all new cases of lung cancer diagnosed histologically or cytologically from 01 January 2000 to 31 December 2000, and from 01 January 2010 to 31 December 2010, and managed in the respiratory department of one of the participating general hospitals. A standardized form was completed for each patient. A steering committee checked recruitment exhaustiveness.

    Results
    137 hospitals in 2000 and 104 hospitals in 2010 included respectively 5667 and 7051 patients. The 2 cohorts represented about 1 in 5 lung cancers diagnosed in France in 2000 and 2010. The characteristics of patients and lung cancer changed during the 10-year period in France. In 2010, compared to 2000, patients were older (mean (SD): 65.5 (11.3) years vs. 64.3 (11.5) years; p<0.0001), more frequently women (24.3% vs. 16.0%; p<0.0001) and more frequently never-smokers (10.9% vs. 7.2%; p<0.0001); they had a lower performance status score (PS) at diagnosis (PS 3 or 4: 12.7% vs. 17.7%; p<0.0001); their tumor was more frequently an adenocarcinoma (45.4% vs. 29.0%; p<0.0001). One-year mortality also changed, decreasing from 61.8% in 2000 to 56.4% in 2010. Multivariate analysis showed that the year of diagnosis was an independent risk-factor for death. Other independent risk-factors were older age, male sex, higher PS, active smoking, and small cell lung cancer (please see the table hereafter).

    	Odds ratio	95% CI	p-value
    Year of diagnosis
    2000	1 (Ref)
    2010	0.84	0.77-0.91	<0.0001
    Age (years)
    <60	1 (Ref)
    60-75	1.03	0.94-1.13	0.55
    >75	1.53	1.35-1.42	<0.0001
    Sex
    Female	1 (Ref)
    Male	1.28	1.15-1.42	<0.0001
    Smoking status
    Never-smoker	1 (Ref)
    Former-smoker	1.02	0.87-1.19	0.84
    Active-smoker	1.23	1.05-1.44	0.01
    Performance status
    0- Asymptomatic	1 (Ref)
    1- Symptomatic but completely ambulatory	2.45	2.23-2.69	<0.0001
    2- Symptomatic, < 50% in bed	6.49	5.73-7.36	<0.0001
    3- Symptomatic, > 50% in bed	15.2	12.6-18.3	<0.0001
    4- Bedbound	39.0	23.5-64.8	<0.0001
    Small cell lung cancer
    Yes	1 (Ref)
    No	0.83	0.74-0.93	0.002

    Conclusion
    In 10 years, 1-year mortality decreased in patients with primary lung cancer. The improvement in survival was not solely due to epidemiological changes in patient characteristics (age, sex, smoking habits, or PS) and tumor characteristics (histological type) over the 10-year period. This supports the hypothesis of improved management of lung cancer in patients followed up in French general hospitals.