Abstract 877: Impact of histology and gender on lung cancer survival: a population based study

Abstract

Abstract Purpose: The magnitude of the lung cancer epidemic combined with a change in proportion of gender and histological subtypes underscore the need to identify survival trends with a focus on underlying gender and histology variations as to better target prevention, screening, research and treatment efforts. Materials and Methods: We present complete national data on 40,118 lung cancer cases prospectively collected in The Cancer Registry of Norway the last 20 years (1988-2007). One and 5-year overall relative survival rates (RSR) were computed with 95% confidence intervals (CI) for each of the four successive 5-year periods of diagnosis stratified by gender, histological subgroups, age and stage. Results: A significant increase in overall 5-year RSR from the first to last 5-year period was observed for both men and women, in women from 10.1% (95% CI: 8.8% − 11.4%) to 15.4% (95% CI: 14% − 16.9%), and in men from 7.9% (95% CI: 7.1% − 8.7%) to 11.6% (95% CI: 10.5% − 12.8%). Five-year RSR were significantly higher for women than for men in all periods. Also 1-year RSR increased significantly, in women from 30.6% (95% CI: 28.7% − 32.5%) in 1988-1992 to 40.9% (95% CI: 39.5% − 42.4) in 2003-2007. In men, the corresponding rates were 28.2% (95% CI: 27%-29.4%) and 35.3% (95% CI: 34.2%-36.5%), respectively. Five-year RSR were lowest in patients diagnosed with small cell carcinoma, with no significant survival improvement over time in either gender, whereas in adenocarcinoma in women, and squamous cell carcinomas in both genders long-term relative survival rates improved significantly. Women diagnosed with adenocarcinoma had significantly higher 5-year RSR compared to men the three last 5-year periods studied. This gender difference was not significant in other histological subtypes. In both men and women, increasing age was associated with decreasing 1- and 5-year RSR. In women, a significant improvement in 5-year RSR was observed in all age groups from 50-79 years over the 20-year period. Women with localized disease at time of diagnosis had significantly better 5-year relative survival compared to men with localized disease throughout the period studied. In 2003-2007, 5-year RSR for localized disease were 51.8% (95% CI: 46.5%-56.8%) in women and 40.9% (95% CI: 36.1%-45.9%) in men. Conclusion: These complete national data highlight important prognostic characteristics of the lung cancer epidemic in Norway that presumably can be extrapolated to most developed countries. Improvements in short-term survival rates and modest but statistically significant improvements in long-term survival rates are encouraging; however long-time survival still remains poor. The apparent gender differences in survival should be a focus of further research. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 877.