Author of

• 16489

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  P1.01 - Poster Session with Presenters Present (ID 453)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Epidemiology/Tobacco Control and Cessation/Prevention
  • Presentations: 2
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16505

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    P1.01-016 - An International Epidemiological Analysis of Young Patients Diagnosed with NSCLC (AduJov - CLICaP) (ID 6296)

    14:30 - 14:30  |  Author(s): O. Castillo-Fernandez
    • Abstract

    Background:
    Eventhough lung cancer remains a disease of a median age at diagnosis of 70y, a proportion of patients are diagnosed at 40y or younger. Patients diagnosed before the age of 40 tend to be never-smokers, are stage IV adenocarcinoma, and tend to have an EGFR activating mutation or a EML4-alk translocation. It is crucial to determine the epidemiological characteristics of patients younger than 40y. Our study groups the largest population of patients less than 40y diagnosed with NSCLC.
    
    Methods:
    In this epidemiological retrospective study, 249 patients (Argentina=6, Canada=19, Colombia=29, Costa Rica=9, Mexico=89, Nicaragua=2, Panama=19, and Peru=76) with a histologically confirmed NSCLC aged 40 years or less at diagnosis were included. Data included age, gender, histology, stage, EGFR and alk mutation analysis, and date of death or last follow-up. Progression free survival (PFS) and overall survival (OS) were also recorded.
    
    Results:
    NSCLC patients aged 40 years or less accounted around a 4% of the total NSCLC population. Median age was 34.5 years (range 14-40), 137 (55%) were women, and 192 patients (77.1%) were non-smokers. Adenocarcinoma was the most frequent histological subtype with 203 patients (81.6%) and 24 patients (9.6%) were squamous. 214 patients (85.9%) were stage IV and 23 patients (9.2%) were stage III at diagnosis. The site(s) of metastasis was obtained in 203/214 stage IV patients where 39.9% (n=81) had lung, 35.6% (n=72) had SNC, and 31.7% (n=64) had bone metastasis. EGFR mutation (EGFRm) analysis was determined in 103 patients with 40 patients (38.8%) having an EGFRm. EML4-alk analysis was determined in 165 patients with 11 patients having a positive translocation (6.7%). The OS for all patients was 14.4 months (95%CI=11.2-17.6), PFS was 5.7 months (95%CI=4.9-6.5), and there was no significant difference according to histological subtype. OS for EGFRm(+) was 42 months (95%CI=30.8-54.0) and for EGFRm(-) was 19.4 months (95%CI=14.8-24.0) (p=0.002); PFS for EGFRm(+) was 11.9 months (95%CI=6.3-17.5) and for EGFRm (-) was 7.1 months (95%CI=5.3-8.9) (p=0.005). OS for alk(+) was 28.0 months (95%CI=15.4-40.6) and for alk(-) was 10.6 months (95%CI=6.9-14.3) (p=0.065).
    
    Conclusion:
    NSCLC patients aged 40 years or less constitute a small but important proportion of patients with this diagnosis. Other risk factors may be involved in the pathogenesis of the disease in this population due to a low smoking history found. SNC metastasis at diagnosis seems to be more frequent in this population. EGFR mutation and EML4-alk translocation frequency is higher than the frequency reported in the general population.
    
    

  • 16513

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    P1.01-024 - University Students' Perceptions about Effectiveness of MPOWER Policies on Tobacco Control in Panama City Panama (ID 5485)

    14:30 - 14:30  |  Author(s): O. Castillo-Fernandez
    • Abstract

    Background:
    Tobacco use is a leading preventable cause of disease, disability and death worldwide. To expand the fight against the tobacco epidemic, WHO has introduced the MPOWER package of six proven policies:1.- Monitor tobacco use and prevention policies, 2.- Protect people from tobacco smoke, 3.- Offer help to quit tobacco use 4.-Warn about the dangers of tobacco 5.-Enforce bans on tobacco advertising, promotion and sponsorship, and 5.-Raise taxes on tobacco. The aim of this study was to evaluate the student´s perception about the effectiveness of each intervention.
    
    Methods:
    Students from public and private universities in Panama city were surveyed. Students were asked to evaluate each policy in a binary answer (less effective or very effective). Chi squared test was used to compare answers between smokers and never smokers
    
    Results:
    302 students answered the questionnaire: 157 females (52%) and 145 males (48%). Median age was 21 years. There were 73 smokers (24.2%) and 229 never smokers (75.8%). Median age of start smoking was 16 years (10-25), median of cigarettes per week was 6 (1-48). There were not discrepancies in effectiveness between the two groups in monitoring tobacco use policies (p=0.31). 56% of never smokers and 28% of smokers considered that protect people from tobacco smoke is very effective (p<0.001). Offer help to quite tobacco is considered very effective in 31% of smokers versus 52% of never smokers (p=0.003). To require effective package warning labels is very effective in 24.6% of smokers and 48% of never smokers (p<0.0001). Implement counter-tobacco advertising is equally effective for half of both groups (p=0.06). To obtain free media coverage of anti-tobacco activities is very effective in 53% of never smokers and 32% of smokers (p= 0.002). To enforce bans on tobacco advertising promotion and sponsorship is very effective in 46% of never smokers and 52% of smokers (p=0.34). Increase tax rates for tobacco products and ensure that they are adjusted periodically to keep pace with inflation and rise faster than consumer purchasing power is very effective for 46% of smokers and 57% of never smokers (p=0.09). Strengthen tax administration to reduce the illicit trade in tobacco products did not show difference in effectiveness of both groups (p=0.15).
    
    Conclusion:
    MPOWER policies are useful to prevent smoking. The perception of the effectiveness of each intervention varies according tobacco use.