Abstract
In the United States, lung cancer occurs in about 225,000 patients and causes over 158,000 deaths annually. Due to a shift in smoking patterns between the genders that started decades ago, the incidence of lung cancers appeared to have shifted accordingly. Thus, we analyzed our institutional data as described below. This is a retrospective study that compares two populations of lung cancer patients in two different five-year periods a decade apart: one from 1996 to 2000 consisting of 1355 lung cancer patients and the other from 2011 to 2015 consisting of 2220 lung cancer patients from our institutional tumor registry data. We included lung cancers that have been associated with smoking such as adenocarcinoma, squamous cell carcinoma, and small cell lung cancer. The two populations were compared in category of gender; race and marital status were also included to examine any major population shifts during these time periods. Crude survival at two-year follow up period was also examined. The results were analyzed using Excel as well as Matlab. This project is IRB approved. From 1996 to 2000, the percentage of male population with lung cancer associated with smoking was 63%. This number decreased significantly to 51% in the period 2011-2015 (p-value < 0.00001). The percentage of African American patients in 1996-2000 was 14% and decreased to 11% in 2011-2015 (p-value 0.0039). The number of divorced patients increased from 8.1% to 11% (p-value 0.0025). The number of widowed patients decreased from 12.3% to 9.8% (p-value 0.0096). For patients with stage IV lung cancer diagnosed from 1996 to 1998, the crude survival rate at 2-year follow up was 17%, which increased to 29% in patients diagnosed from 2011 to 2013 (p-value < 0.00001). Our results demonstrate that the proportionate incidence of lung cancer in males has decreased significantly from the late 90s to the early 2010s. The change in race and marital status, while statistically significant, is less dramatic. The percentage of African American population has also decreased significantly. The crude survival rate at 2 year follow up for those with stage IV lung cancer significantly increased. While this could, in part, be due to stage migration, a real prolongation due to improvements in systemic therapy is likely. More attention should be drawn to the fact that nearly twice as many women die from lung cancer compared to breast cancer, for a more proportionate support of research efforts.
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