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Trends in survival from metastatic lung cancer in California, 1990-2014

Trends in survival from metastatic lung cancer in California, 1990-2014. Rosemary D. Cress, DrPH Amy K. Klapheke, MPH, PhD Public Health Institute Cancer Registry of Greater California. Introduction. Lung cancer incidence in California has declined steadily thanks to reduction in smoking

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Trends in survival from metastatic lung cancer in California, 1990-2014

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  1. Trends in survival from metastatic lung cancer in California, 1990-2014 Rosemary D. Cress, DrPH Amy K. Klapheke, MPH, PhD Public Health Institute Cancer Registry of Greater California

  2. Introduction • Lung cancer incidence in California has declined steadily thanks to reduction in smoking • But lung cancer remains the leading cause of cancer death. • Most patients are diagnosed after the cancer has spread, and prognosis is poor. • However recent improvements in treatment for metastatic lung cancer have improved survival for some patients.

  3. Purpose • The purpose of this study was to evaluate trends in survival by gender, race/ethnicity, and histologic type for patients diagnosed with metastatic lung cancer in California.

  4. Methods • Through the California Cancer Registry, we identified patients diagnosed with a first primary lung cancer diagnosed at remote/distant (metastatic) stage between 1990 and 2014 with follow up through December 2015. • Race/ethnicity was categorized into non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic, and Asian/Pacific Islander (API). • Histologic subtype was categorized into small cell lung cancer (SCLC), squamous cell carcinoma (SCC), adenocarcinoma, large-cell carcinoma (LCC), non-small cell lung cancer, not otherwise specified (NSCLC, NOS), and other/unknown.

  5. Statistical analysis • One-year relative survival was calculated overall and by age at diagnosis, sex, race/ethnicity, and histology for each year in the study period. • Joinpoint Regression was used to evaluate trends and to calculate the estimated annual percentage rate change (APC).

  6. Results • A total of 186,156 adults with metastatic lung cancer were identified for analysis.

  7. Characteristics of patients with metastatic lung cancer, 1990-2014, California

  8. Characteristics of patients with metastatic lung cancer, 1990-2014, California (cont.)

  9. Relative Survival of Patients with Metastatic Lung Cancer, 1990-2014 , California

  10. Annual percent change in 1-year relative survival, by time period and age, 1990-2014, California

  11. Annual percent change in 1-year relative survival, by gender and race, 1990-2014, California

  12. Annual percent change in 1-year relative survival, by histologic type, 1990-2014, California

  13. Summary of results • Survival for patients with metastatic lung cancer improved over the past 25 years. One-year survival increased from 18.4%-29.4% • Improvement was seen in almost all groups, but was particularly pronounced for women (19.9%-33.3%), for API’s (26.0%-43.6%) and for those with adenocarcinoma (18.4%-38.2%). • We also observed increases in five-year survival for patients diagnosed 1988-2010, from 2.2%-5.0%.

  14. Conclusions • While long term survival for patients with metastatic lung cancer continues to be very poor, one year survival has improved over the past twenty-five years. • This likely reflects improvements in treatment for these patients, in particular specific chemotherapy and molecularly targeted therapies.

  15. Acknowledgements • Tianhong Li, MD, PhD • Associate professor • Division of Hematology & Oncology, Department of Internal Medicine, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA

  16. Questions? Contact: Rosemary D. Cress, DrPH Research Program Director, SEER Principal Investigator Public Health Institute, Cancer Registry of Greater California rcress@crgc-cancer.org

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