Abstract
The average time required for cancers to progress through stages can be reflected in the average age of the patients diagnosed at each stage of disease. To estimate the time it takes for non-small-cell lung cancer (NSCLC) to progress through different tumor, node and metastasis (TNM) stages and sizes, we compared the mean adjusted age of 45904 NSCLC patients with different stages and tumor sizes from Surveillance, Epidemiology and End Results (SEER) cancer registry database and our institute. Multiple-linear-regression models for age were generated adjusting for various factors. Caucasian, African-American and Asian patients with stage IA cancers were on average 0.8, 1.0 and 1.38 adjusted years younger, respectively, than those with stage IIIB cancers (p < 0.001). And these with T1a cancers were on average 0.84, 0.92 and 1.21 adjusted years younger, respectively, than patients with T3 cancers (p < 0.001). Patients with tumors measuring larger than 8 cm in diameter were on average 0.85 adjusted years older than these with tumors smaller than 1 cm (p < 0.001), with Caucasian demonstrating the shortest age span (0.79 years, P < 0.001). In conclusion, the time-to-progression of NSCLC from early to advanced stages varied among ethnicities, Caucasian patients demonstrating a more rapid progression nature of tumor than their African-American and Asian counterparts.
Highlights
Lung cancer is the leading cause of cancer-related death in both men and women worldwide[1]
If the average time required for non-small-cell lung cancer (NSCLC) to progress through its different stages is long enough, the average age differences of the patients diagnosed at each stage can be presumed to be the stage-to-stage time intervals[9]
The average age at diagnosis (AAD) of lung cancer patients was compared after adjusting for cofactors to estimate the average time it takes lung cancers to grow within and through different stages and sizes
Summary
Lung cancer is the leading cause of cancer-related death in both men and women worldwide[1]. The advancements in thoracic imaging have increased the incidence of detection of small solitary pulmonary nodules (SPNs)[2,3]. Treatment decisions for these lesions must weigh the risks and benefits of prompt identification of malignant nodules to avoid surgery in patients with benign nodules. Given that a lesion’s growth pattern can largely reflect its malignancy, a better understanding of the natural development processes of the early clinical stages of lung cancer has instructive significance in present surveillance guidance for lung cancer screening when a small sized SPN is detected[4]. Correspondence and requests for materials should be addressed to J.H. (email: hujian_med2@163. com) www.nature.com/scientificreports/
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