Epidemiologic Study of Overall Survivability of Individuals Diagnosed With Lung and Bronchus Cancer in Michigan Between the Years 1996 to 2017

Document Type

Conference Proceeding

Publication Date

5-21-2024

Publication Title

Am J Respir Crit Care Med

Abstract

RATIONALE: Lung and bronchus cancer is a leading cause of death in the United States. Between the years 2013-2019, the national relative survival for lung and bronchus cancer was 25.4%. Compared to the national average, Michigan has an increased mortality rate, and low early screening and treatment rates. Additionally,to date, there is no epidemiologic study investigating survival rates based on race in Michigan. This study aimed to explore the epidemiological trends of patients diagnosed with lung and bronchus cancer in Michigan, compare primary location and stage of diagnosis upon detection and asses overall survival (OS). METHODS: Data was acquired from the Michigan Cancer Surveillance Program (MCSP). Study population consisted of individuals between the ages of 18-90 diagnosed with Lung or Bronchus cancer in Michigan during years 1996 to 2017. Patients with incomplete data for race, gender and survival time were excluded. Log Rank test was used to test OS among three time periods, Univariant and Multivariate Cox Regression Model was employed to determine factors which significantly affected OS. RESULTS: 153,742 individuals met inclusion criteria; 54.22% male and 45.78% female. Mean age at diagnosis was 69 years (SD=10.86). Majority of individuals were White Non-Hispanic and lived in a Metropolitan community. Median OS was 8 months with an Interquartile range (IQR) of 2-21 months. Majority of lung and bronchus cancers were diagnosed in late stages when distant site/nodes were involved (44.44%) and only 19.0 % of tumors were localized. Univariate analyses identified four individual characteristics associated with reduced OS: age at diagnosis, male sex, American Indian race, and living in rural or urban area. Multivariant analyses identified three races associated with improved OS: Asian race, Black non-Hispanic race, Hispanic non-white non-black race. OS was reduced if the primary tumor site was mainstem bronchus (including the bronchus intermedius), lung base, overlapping lesions of lung lobes or otherwise not specified. SEER stage 7 (presence of distant sites/nodes) was associated with reduced OS HR 1.19 (95% CI 1.17-1.21 ) p<0.001. Log rank test showed no significant difference in OS among the three time-periods (P =0.99).CONCLUSIONS: In addition to TMN stage, several factors are associated with reduced survivability in Michigan residents with lung and bronchus cancer. Consideration of these factors may be helpful as a community outreach tool to help increase early detection, reduce overall mortality and explain the lack of treatment in Michigan residents when compared to the national average.

Volume

209

Issue

9

First Page

A1436

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