Survival and Racial Differences of Non-Small Cell Lung Cancer in the United States Military.

MedStar author(s):
Citation: Journal of General Internal Medicine. 30(10):1406-12, 2015 Oct.PMID: 25805503Institution: Washington Cancer InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, Non-U.S. Gov'tSubject headings: *Carcinoma, Non-Small-Cell Lung/eh [Ethnology] | *Carcinoma, Non-Small-Cell Lung/mo [Mortality] | *Continental Population Groups/eh [Ethnology] | *Lung Neoplasms/eh [Ethnology] | *Lung Neoplasms/mo [Mortality] | *Military Personnel | Adolescent | Adult | Aged | Carcinoma, Non-Small-Cell Lung/di [Diagnosis] | Cohort Studies | Female | Humans | Lung Neoplasms/di [Diagnosis] | Male | Middle Aged | Retrospective Studies | Survival Rate/td [Trends] | United States/ep [Epidemiology] | Young AdultYear: 2015Local holdings: Available online from MWHC library: 1997 - present (after 1 year), Available in print through MWHC library: 1999 - 2006ISSN:
  • 0884-8734
Name of journal: Journal of general internal medicineAbstract: BACKGROUND: Lung cancer is the leading cause of cancer-related death in the United States (US) Military and worldwide, with non-small cell lung cancer (NSCLC) accounting for 87 % of cases.CONCLUSION: The lack of significant outcome disparity between AAs and Caucasians and the earlier stage at diagnosis than usually seen in civilian populations suggest that equal access to healthcare may play a role in early detection and survival.DESIGN AND PARTICIPANTS: We conducted a retrospective cohort analysis of 4,751 patients, aged > 18 years and diagnosed with a first primary NSCLC between 1 January 2003 and 31 December 2013 in the US Department of Defense (DoD) cancer registry.MAIN MEASURES: Differences by patient and disease characteristics were compared using Chi-square and t-test. Kaplan Meier curves and Cox proportional hazards regression assessed overall survival.OBJECTIVES: Using a US military cohort who receives equal and open access to healthcare, we sought to examine demographic, clinical features and outcomes with NSCLC.RESULTS: The mean age at diagnosis was 66 years, 64 % were male, 72 % were Caucasian, 41 % were diagnosed at early stage, 77 % received treatment and 82 % had a history of tobacco use. Mean age at diagnosis was highest among Caucasians (67 years) and lowest among African Americans (AA; 62 years). Asian/Pacific Islanders (PI) were more likely to be female (p<0.0001), have adenocarcinoma histology (p=0.0003) and less likely to have a history of tobacco use (p<0.0001) compared to other racial/ethnic groups. In multivariable survival analysis, older age, male gender, increasing stage, not receiving treatment, and tobacco history were associated with higher mortality risk. Untreated patients exhibited a 39 % higher mortality risk compared to treated patients (HR = 1.39; 95%CI = 1.23-1.57). Compared to Caucasian patients, Asian/PIs demonstrated a 20 % lower risk of death (HR = 0.80; 95%CI = 0.66-0.96). There was no difference in mortality risk between AAs and Hispanics compared to Caucasians.All authors: Brzezniak C, Carter CA, Gallagher C, Goertz HP, Gunuganti A, Reyes C, Satram-Hoang SFiscal year: FY2016Digital Object Identifier: Date added to catalog: 2016-07-15
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 25805503 Available 25805503

Available online from MWHC library: 1997 - present (after 1 year), Available in print through MWHC library: 1999 - 2006

BACKGROUND: Lung cancer is the leading cause of cancer-related death in the United States (US) Military and worldwide, with non-small cell lung cancer (NSCLC) accounting for 87 % of cases.

CONCLUSION: The lack of significant outcome disparity between AAs and Caucasians and the earlier stage at diagnosis than usually seen in civilian populations suggest that equal access to healthcare may play a role in early detection and survival.

DESIGN AND PARTICIPANTS: We conducted a retrospective cohort analysis of 4,751 patients, aged > 18 years and diagnosed with a first primary NSCLC between 1 January 2003 and 31 December 2013 in the US Department of Defense (DoD) cancer registry.

MAIN MEASURES: Differences by patient and disease characteristics were compared using Chi-square and t-test. Kaplan Meier curves and Cox proportional hazards regression assessed overall survival.

OBJECTIVES: Using a US military cohort who receives equal and open access to healthcare, we sought to examine demographic, clinical features and outcomes with NSCLC.

RESULTS: The mean age at diagnosis was 66 years, 64 % were male, 72 % were Caucasian, 41 % were diagnosed at early stage, 77 % received treatment and 82 % had a history of tobacco use. Mean age at diagnosis was highest among Caucasians (67 years) and lowest among African Americans (AA; 62 years). Asian/Pacific Islanders (PI) were more likely to be female (p<0.0001), have adenocarcinoma histology (p=0.0003) and less likely to have a history of tobacco use (p<0.0001) compared to other racial/ethnic groups. In multivariable survival analysis, older age, male gender, increasing stage, not receiving treatment, and tobacco history were associated with higher mortality risk. Untreated patients exhibited a 39 % higher mortality risk compared to treated patients (HR = 1.39; 95%CI = 1.23-1.57). Compared to Caucasian patients, Asian/PIs demonstrated a 20 % lower risk of death (HR = 0.80; 95%CI = 0.66-0.96). There was no difference in mortality risk between AAs and Hispanics compared to Caucasians.

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