FP02.02 The Impact of Sex on Non-Small Cell Lung Cancer Survival in Canada

Abstract

Lung cancer is the leading cause of cancer-related death in Canada. Non-small cell lung cancer (NSCLC) accounts for the majority of lung cancer cases, and while new treatments have been developed, survival outcomes remain poor. Literature from outside Canada indicates differences in NSCLC survival by sex. These differences cannot be explained by differences in stage, NSCLC subtype, age, or smoking history, indicating that sex may be an independent prognostic factor. The impact of sex on NSCLC survival has yet to be thoroughly examined in the Canadian context. Here we evaluate the impact of sex on survival outcomes among a population-based Canadian cohort of lung cancer patients. A retrospective cohort study was completed using real-world data from the Glans-Look Lung Cancer Database (GLD). The GLD contains demographic, clinical, pathological, treatment, and outcome data for all individuals diagnosed with NSCLC in Alberta, Canada, between 2010 and 2017. Descriptive statistics were used to characterize the cohort. To analyze the impact of sex on NSCLC survival, Kaplan-Meier estimators with log rank tests were used for comparisons between cohorts grouped by sex, stage, and subtype. Overall survival was defined as time from diagnosis to death from any cause. 8193 patients with complete data were included in analyses. Median age was 69.30 years (IQR 61.85-76.19), with 49.35% of the cohort being female. Median overall survival was 12.73 months (IQR 4.83–28.07), with 6277 (76.61%) patients deceased at end of follow-up. The highest proportion of cases (49.04%) were stage IV at diagnosis, and the most common histological subtypes were adenocarcinoma (55.35%), squamous cell carcinoma (SCC) (24.68%), and pathologically not otherwise specified (NOS) (9.79%). Survival analyses by stage indicated females had longer survival than males at every stage of diagnosis (p<0.01) (Figure). Analyses by subtype indicated that amongst those with adenocarcinoma, SCC, or pathological NOS, females had longer survival than males (p<0.01). Analyses by stage and subtype showed longer female survival for all stages of adenocarcinoma (p<0.01), and stage IV SCC (p<0.01) and pathological NOS (p=0.02) compared to males. These preliminary analyses suggest that females with NSCLC have longer survival than males with NSCLC at all stages of disease, and within the most common histological subtypes. These analyses suggest that survival trends among Canadian NSCLC patients are similar to those seen in other western countries, and that further research is needed to elucidate the consideration of sex as an independent prognostic factor for NSCLC.