Abstract
Background
Lung cancer is the second most common cancer worldwide and the leading cause of death for cancer (18.4%). During the last 30 years, lung cancer incidence and mortality increased in women and decreased in men, because of tobacco smoking exposure. Population survival trend reflects both the influence of disease severity at diagnosis and treatment effectiveness. Some studies reported an increase in global lung cancer survival and linked it to new treatment options. However, change in the overall survival may also reflect a shift towards morphologies with more favorable prognosis. We analyzed overall and morphology specific survival trends for lung cancer to gain insight on the role of new treatments and changing exposures.
Methods
We analyzed lung cancer 1 y-survival and 3 y-survival after diagnosis in Umbria (890'000 inhabitants) in the period 1994-2016. Population-based data were obtained from the Umbrian Cancer Registry (RTUP), Italy. We estimated relative net survival (Pohar-Perme approach) stratified both for sex and histotype (NSCLC, SCLC, NOS), considering six diagnostic periods from 1994 to 2016 (4 years for period, except 3 in the last one) for 5'268 lung cancer cases (26% women).
Results
Overall survival by gender resulted 40,5% (1y) and 16.5% (3y) in men, 47,3% (1y) and 23,2% (3y) in women. NSCLC survival increased in women during the period 1994-2016 from 41% to 53% (1y) and from 23% to 33% (3y), and remained unchanged in men. SCLC 3 year-survival did not change significantly neither in women nor in men.
Conclusions
We did not observe a significant increase in lung cancer survival over a 25 years period. We observed a significant increase in survival probabilities for NSCLC among women only. Thus, our data don't confirm a major role of new treatments in improving lung cancer control. We will provide further analyses for adenocarcinoma and a comparison of incidence and mortality trends to understand the influence of exposures and treatments on survival.
Key messages
A general increase in lung cancer survival, as could be expected after the introduction of new highly effective treatments is not present in western countries. Reducing exposure to tobacco smoking and environmental pollution remain the main intervention to improve lung cancer control.
The role of receipt and timeliness of treatment in socioeconomic inequalities in lung cancer survival: population-based, data-linkage study
