An Actuarial Approach to Comparing Early Stage and Late Stage Lung Cancer Mortality and Survival

2010 ◽  
Vol 13 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Sara W. Goldberg ◽  
James L. Mulshine ◽  
Dale Hagstrom ◽  
Bruce S. Pyenson
Keyword(s):  
Lung Cancer ◽  
Cancer Mortality ◽  
Late Stage ◽  
Early Stage ◽  
Lung Cancer Mortality ◽  
Actuarial Approach ◽  
Stage Lung Cancer

“Early impact” of the lung cancer screening in United States population in the SEER Registries.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 1569-1569
Author(s):  
Isabel M Emmerick ◽  
John M. Varlotto ◽  
Maggie M Powers ◽  
Feiran Lou ◽  
Poliana Lin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Cancer Mortality ◽  
Late Stage ◽  
Early Stage ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
Median Income ◽  
Early Late ◽  
Patient Subgroups

1569 Background: The Lung Cancer Screening Trial (NLST) demonstrated improved overall survival (OS) and lung cancer specific survival (LCSS), likely due to finding early-stage NSCLC. Our study investigates the impact of the NLST publication in 2011 on the lung cancer outcomes in the general US Population by assessing the incidence rates, ratio of early/late stage, and lung cancer mortality in the years immediately prior to and following this publication. Methods: Rate sessions from the SEER18 database were accessed during the years 2008-2015. We analyzed overall lung cancer incidence and mortality rates. The ratio of early/late stage was obtained by dividing the number of stage I and II cases by the number of stage III and IV diagnosed by year. We investigate changes in level and trend using interrupted time series in STATA12, considering 2011 as the intervention. In addition, we performed a T-test for averages ratios comparing the years 2007-2010 to the years 2012-2015 for the entire lung cancer population and for subgroups by median family, ethnicity, Sex, Age and SEER Registry. Results: Although the overall lung cancer rates remained stable during the study period, a significant increase in the ratio of early/late stage was observed following the release of NLST for the overall lung cancer population (p=0.006) and for the screening age group (p= 0.014). The effects of ratio of early/late stage as noted in the overall group persisted for all patient subgroups, except for patients associated with a median income <$40,000, for those there were white, and for the following regions Detroit Metro, Iowa, Greater and Rural Georgia and Louisiana where no association was found between the release of the NLST changes in the ratios of early detection even more, in some cases there was a decrease in late stage detection. There was no impact on lung cancer mortality in the general lung cancer population or in any patient subgroups. Conclusions: Since the publication of the NLST in 2011, there has been no impact on lung cancer mortality or incidence of lung cancer in the general US population. However, favorable increase in the proportion of early stage lung cancers, depending upon median family income, race and location. We expected a greater impact of lung cancer screening after 2015 since CT-screening for lung cancer was adopted by CMS and other insurances during that year.

scholarly journals Lung Cancer Attributed Mortality Among 316,336 Early Stage Breast Cancer Cases Treated by Radiotherapy and/or Chemotherapy, 2000–2015: Evidence From the SEER Database

2021 ◽  
Vol 10 ◽  
Author(s):  
Semaw Ferede Abera ◽  
Rafael T. Mikolajczyk ◽  
Eva Johanna Kantelhardt ◽  
Ljupcho Efremov ◽  
Ahmed Bedir ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
General Population ◽  
Alaska Native ◽  
Cancer Mortality ◽  
Early Stage ◽  
Lung Cancer Mortality ◽  
Tumor Grade ◽  
Parametric Modelling ◽  
Risk Of Death

ObjectiveTo estimate the risk of death from lung cancer in patients treated for breast cancer (BC) in relation to the general population.MethodsBC data, covering 2000 to 2015, were extracted from the Surveillance, Epidemiology and End Results-18 (SEER-18) cancer registry database. A comparison of lung cancer attributed mortality between BC patients and the general population was performed using standardized mortality ratios (SMRs) and SMRs conditional on survival length (cSMRs). Prognostic factors of lung cancer mortality were identified using flexible parametric modelling. Our model adjusts the effect of downstream (histopathological BC tumor grade and hormone receptor status) and upstream (age at diagnosis, ethnicity, and marital status) factors.ResultsThe median follow-up was 6.4 years (interquartile range, 3.0–10.3 years). BC cases who received only radiotherapy (cSMR = 0.93; 95%CI: 0.77–1.13), only chemotherapy (cSMR = 0.91; 0.62–1.33), and radio-and chemotherapy (cSMR = 1.04; 0.77–1.39) had no evidence of increased lung cancer mortality relative to the general population. The adjusted model identified that lung cancer mortality was higher for women who were older at diagnosis compared to those &lt;50 years (ranging from HR50-59 = 3.41 [95%CI: 2.72–4.28] to HR70-79 = 10.53 [95%CI: 8.44–13.13]) and for cases with negative estrogen and progesterone receptors (HR =1.38; 95% CI: 1.21–1.57). Compared to married cases, widowed, divorced, single or others had a 76%, 45%, and 25% higher hazard of lung cancer mortality, respectively. Lung cancer mortality was lower for American Indian/Alaska Native and Asian/Pacific Islander ethnicities (HR = 0.51; 95% CI: 0.40–0.64) compared to BC cases with white ethnic background.ConclusionsThere is no evidence for a higher lung cancer mortality in BC patients when compared to the general population.

scholarly journals The Prognostic Significance of PD1 and PDL1 Gene Expression in Lung Cancer: A Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Chih-Hao Chang ◽  
Arthur Chun-Chieh Shih ◽  
Ya-Hsuan Chang ◽  
Hsuan‐Yu Chen ◽  
Ying-Ting Chao ◽  
...  
Keyword(s):  
Gene Expression ◽  
Lung Cancer ◽  
Cell Death ◽  
Programmed Cell Death ◽  
Immune Checkpoint ◽  
Late Stage ◽  
Early Stage ◽  
Meta Analysis ◽  
Risk Of Relapse ◽  
Stage Lung Cancer

BackgroundImmune checkpoint blockade therapy represents an extraordinary advance in lung cancer treatment. It is important to determine the expression of immune checkpoint genes, such as programmed cell death 1 (PD1) and programmed cell death-ligand 1 (PDL1), to develop immunotherapeutic strategies. The aim of this study was to explore the association between PD1 and PDL1 gene expression and prognoses and outcomes in lung cancer.MethodsThis meta-analysis analyzed 1,251 patients from eight different microarray gene expression datasets and were evaluated for their prognostic implications and verified using another independent research.ResultsThe mean expression levels of PDL1 in adenocarcinoma (AD) and squamous cell carcinoma (SC) were significantly higher in patients who died than in patients who did not. There was a trend toward incremental increases in PD1 and PDL1 expression significantly decreasing the risk of relapse and death among AD patients (HR = 0.69; 95% CI = 0.53 ~ 0.91; HR = 0.68; 95% CI = 0.54 ~ 0.84, respectively) and SC patients (HR = 0.53; 95% CI = 0.32 ~ 0.89; HR = 0.78; 95% CI = 0.57 ~ 1.00 respectively), as early-stage patients in this study were more likely to have high expression of both PD1 and PDL1 than late-stage patients (P-trend &lt; 0.05). In contrast, late-stage SC patients expressing one or more of the genes at a high level had a significantly elevated risk of relapse (HR = 1.51; 95% CI = 1.07 ~ 2.11) and death (HR = 1.41; 95% CI = 1.08 ~ 1.84). This result was consistent with the validation data set.ConclusionThese findings indicate that high expression of PD1 and PDL1 is associated with superior outcome in early-stage lung cancer but an adverse outcome in late-stage lung cancer. The expression levels of PD1 and PDL1 individually or jointly are potential prognostic factors for predicting patient outcomes in lung cancer.

PO-1103 Lung Cancer Mortality Among 316,336 Radiotherapy-Treated Early Stage Breast Cancer Cases

2021 ◽  
Vol 161 ◽  
pp. S917-S918
Author(s):  
S. Abera ◽  
R. Mikolajczyk ◽  
E. Kantelhardt ◽  
L. Efremov ◽  
A. Bedir ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Cancer Mortality ◽  
Early Stage ◽  
Lung Cancer Mortality ◽  
Early Stage Breast Cancer
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