Improvement in lung cancer survival: Six-year survival analysis of patients diagnosed between 2011 and 2016 in Hungary.

Abstract

e21582 Background: Lung cancer is one of the most common cancers worldwide, however, 5-year survival is poor, only 10-20% of pataients survive this period. To date, no long-term study has been conducted to evaluate long-term survival rates in Hungary. Therefore, the objective of our study was to assess the 6-year survival of lung cancer patients (ICD-10 C34) based on a nationwide review of the National Health Insurance Fund (NHIF) database. Methods: Our retrospective, longitudinal study included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between 1 January 2011 and 31 December 2016. Screening period was set for 2009-2010. Patients with other cancer-related ICD-10 codes 6 months before or 12 months after lung cancer diagnosis and those who received any anticancer treatment different from lung cancer protocols were excluded. Survival rates were evaluated according to year of diagnosis, patient gender and age, and morphology of lung cancer and main treatment type. Results: 41,854 newly diagnosed lung cancer patients were recorded. Mean age at diagnosis varied between 64.66 and 65.88 years during study period. One- and 5-year crude survival rates for the total population were 42.23% and 17.85%, respectively. Survival was significantly associated with gender, age and type of lung cancer based on statistical association. Female patients (n = 16,362) had 23% better survival (HR: 0.77 CI95% 0.75-0.79; p < 0.001) than males (n = 25,492). The highest survival rates were found in the 20–49 age cohort (5Y = 31.3%) and if the cancer type was adenocarcinoma (5Y = 20.48%). We measured 5.3 % improvement in lung cancer survival between cases diagnosed in 2015-2016 vs. 2011-2012 (HR: 0.947 CI95% 0.92-0.97; p = 0.003). Survival of those lung cancer patients, whom had surgery in first line treatment without adjuvant therapy (3,120) reached 64.18%, those with adjuvant treatment (n = 2,675) 54.47% 5 year survival, while patients with chemotherapy (n = 11,780) had only 7.9% crude survival. Conclusions: Our study provided long-term LC survival data in Hungary for the first time. We found a 6% improvement in survival by the end of the study period in females and in the younger age groups. Survival rates were comparable to – and at the higher end of – rates registered in other East-Central European countries. Better survival rate of females could be attributed to a higher incidence rate of adenocarcinoma in women. Lung cancer patients diagnosed in early stage had 7-8 times better survival than those found in late stage.