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- Title
A Decade of Never-smokers Among Lung Cancer Patients-Increasing Trend and Improved Survival.
- Authors
Chee-Keong Toh; Whee-Sze Ong; Wan-Teck Lim; Shao-Weng Tan, Daniel; Quan-Sing Ng; Kanesvaran, Ravindran; Wei-Jie Seow; Mei-Kim Ang; Eng-Huat Tan; Toh, Chee-Keong; Ong, Whee-Sze; Lim, Wan-Teck; Tan, Daniel Shao-Weng; Ng, Quan-Sing; Seow, Wei-Jie; Ang, Mei-Kim; Tan, Eng-Huat
- Abstract
<bold>Background: </bold>It is not known whether clinicopathologic characteristics, treatment, and survival of never-smokers among lung cancer incident cases have changed over time. We assessed the trend and overall survival (OS) of these patients within our institution during a 10-year period.<bold>Patients and Methods: </bold>We reviewed 2 cohorts of non-small-cell lung cancer patients with a diagnosis from 1999 to 2002 and from 2008 to 2011. The patient characteristics and OS were compared by smoking status within each cohort and between the 2 cohorts over time.<bold>Results: </bold>Of the 992 patients in the 1999-2002 cohort and the 1318 patients in the 2008-2011 cohort, 902 and 1272 had a known smoking status, respectively. The proportion of never-smokers increased from 31% in 1999-2002 to 48% in 2008-2011 (P < .001). Within both cohorts, the differences in characteristics among never-, former-, and current-smokers have remained largely constant over time. A greater proportion of never-smokers had Eastern Cooperative Oncology Group performance status 0 to 1 and adenocarcinoma. The median OS increased from 15.5 months in 1999-2002 to 24.9 months in 2008-2011 (P = .001) for never-smokers, 12.3 to 15.9 months (P = .150) for former-smokers, and 10.5 to 13.9 months (P = .011) for current-smokers. The larger survival improvement among never-smokers was likely accounted for by the larger increase in never-smokers who were treated with tyrosine kinase inhibitors and pemetrexed over time.<bold>Conclusion: </bold>We found an increasing trend of never-smokers among incident lung cancer cases and improved survival for these patients during a 10-year period. The documentation of smoking status in any national cancer registry is vital to estimate the true incidence of lung cancer among never-smokers over time.
- Subjects
ANTINEOPLASTIC agents; ADENOCARCINOMA; COMPARATIVE studies; LONGITUDINAL method; LUNG cancer; LUNG tumors; RESEARCH methodology; MEDICAL cooperation; PROGNOSIS; RESEARCH; SMOKING; SURVIVAL; EVALUATION research
- Publication
Clinical Lung Cancer, 2018, Vol 19, Issue 5, pe539
- ISSN
1525-7304
- Publication type
journal article
- DOI
10.1016/j.cllc.2018.03.013