Incidences and Trends of Lung Cancer in Western Kenya for the Period Between 2012-2016

Background: Lung cancer diagnosis has been a challenge in western Kenya due to the technicalities related to screening and diagnostic procedures. The burden in the adult population is largely unknown, as most patients are managed for Pulmonary Tuberculosis, since both have similar clinical manifestations. The Eldoret Cancer Registry (ECR) provides statistics and epidemiologic profile across western region of Kenya. Aim: The aim of this study is to establish lung cancer incidences in relation to year of diagnosis, age, gender and stage at diagnosis across western Kenya region. Methods: A retrospective review of all cases of lung cancer disease diagnosed at Moi Teaching and Referral Hospital from 2012 to 2016 were identified from the ECR. Data on year of incidence, age, gender, stage at diagnosis and county of origin was analyzed Results: Out of the 60 patients diagnosed with lung cancer, the findings were as follows: In 2012 there were 11 cases representing 18.3%, 2013 10 cases (16.7%), 2014, 12 cases (20%), 2015 12 cases (20%) and 2016, 15 cases (25%). Incidences by age were in the following cohorts; 0-27 years 1 case representing 1.7%, 30-39 years (4) 6.7%, 40-49 years (8) 13.3%, 50-59 years (17) 28.3%, 60-69 years (12) 20%, 70-79 years (15) 25%, above 80 years (3) 5%. Incidences by gender: male had 38 cases at 63.3% and female had 22 cases at 36.7%. Incidence by stage at diagnosis; stage iv (6) 10%, unknown stage (54) 90%. Conclusion: 2016 had the highest incidence and may be associated with the increased awareness on screening services at MTRH. Most cases were between 50-79 years and could be attributed to the slow disease progression and delays in early diagnosis. Higher incidences were in males and may be related to susceptibilities to risks factors such as smoking and industrial fumes respectively. There's need for early diagnosis and disease staging as most cases were at stage 4 and unknown.

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Comparative Trends in the Distribution of Lung Cancer Stage at Diagnosis in the Department of Defense Cancer Registry and the Surveillance, Epidemiology, and End Results data, 1989–2012

Military Medicine ◽

10.1093/milmed/usaa218 ◽

2020 ◽

Vol 185 (11-12) ◽

pp. e2044-e2048

Author(s):

Joel A Nations ◽

Derek W Brown ◽

Stephanie Shao ◽

Craig D Shriver ◽

Kangmin Zhu

Keyword(s):

Lung Cancer ◽

General Population ◽

Department Of Defense ◽

Stage Iv ◽

Tumor Stage ◽

Stage I ◽

Lower Percentage ◽

Stage At Diagnosis ◽

Nsclc Patients ◽

Two Populations

Abstract Introduction We compared the stage at diagnosis for non-small cell lung cancer (NSCLC) patients in the military healthcare system (MHS) and the general public to assess differences between these two groups as well as to assess the trends in stage at diagnosis in the recent past. Method This study was based on the non-identifiable data from the U.S. Department of Defense Automated Central Tumor Registry (ACTUR) and the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute. Patients diagnosed with NSCLC between 1989 and 2012 were included. The distributions of tumor stage at diagnosis and trends in tumor stage were compared between the two populations. Results The cohorts were predominately male in both ACTUR (65.3%) and SEER (55.1%) and white patients accounted for greater than 80% of patients in both ACTUR and SEER. Among 21,031 patients in ACTUR and 773,356 patients in SEER, stage IV lung cancers predominated (ACTUR 33.6%, SEER 40.5%) followed by stage III (ACTUR 26.1%, SEER 26.4%) and stage I (ACTUR 24.7%, SEER 20.6%). Notable differences between the two populations were the higher percentage of stage I and lower percentage of stage IV, along with a lower rate of unknown stage patients after 2004, in ACTUR than SEER. Between 1989 and 2012, the percentage of stage IV disease increased in ACTUR and SEER coincident with a decrease in unknown stage disease. Conclusions The majority of NSCLC patients in the MHS and general population are diagnosed with stage IV NSCLC and the percentage is increasing. Compared to the general population, NSCLC patients in the MHS have a higher percentage of stage I, a lower percentage of stage IV, and of unknown stage cancer. Universal care along with more rigorous staging across the MHS may play a role in these findings.

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Venous and Lung Thromboembolism in the Context of Lung Cancer: Clinical Manifestations, Risk Factors and Prognosis

Acta Médica Portuguesa ◽

10.20344/amp.10260 ◽

2019 ◽

Vol 32 (10) ◽

pp. 647 ◽

Cited By ~ 1

Author(s):

Rosana Maia ◽

Inês Neves ◽

António Morais ◽

Henrique Queiroga

Keyword(s):

Lung Cancer ◽

Venous Thromboembolism ◽

Cancer Diagnosis ◽

Negative Impact ◽

Clinical Manifestations ◽

Research Subjects ◽

Lung Cancer Diagnosis ◽

The Impact ◽

The Relationship

Introduction: The relationship between cancer and thromboembolic events has been known for a long time. Lung and venous thromboembolism are frequent complications of lung cancer and its treatment, being a great cause of morbidity and mortality. We pretend to establish the relationship between lung and venous thromboembolism and lung cancer, describe patient characteristics and analyze the impact in the survival and prognosis.Material and Methods: It was a retrospective study. All research subjects were selected from lung cancer patients with a newly diagnosed lung and venous thromboembolism event admitted to Hospital S. João, between January 2008 and December 2013 and were followed until December 2014. Statistical analysis was performed with SPSS.Results: From the search, we obtained 113 patients. The majority was male, smokers or ex-smokers, and adenocarcinoma was the most frequent histologic type, being diagnosed mostly in advanced stages. We noticed that the median time between lung cancer diagnosis and lung venous thromboembolism was 2.9 months. In 24 patients (21.4%), the lung cancer diagnosis occurred after the lung and venous thromboembolism event and in 86 patients (76.8%), it occurred before the event. After a median follow up of 1.4 months, 107 (94.7%) patients died, 1 (0.9%) was lost to follow-up and 5 (4.4%) were still alive. The median survival rate was 1.5 months.Discussion: The diagnosis of lung and venous thromboembolism in patients with lung cancer is associated with bad prognosis. It occurs most frequently in patients with advanced disease, in the first months after lung cancer diagnosis and after beginning chemotherapy.Conclusion: Disease progression is an independent predictor with negative impact in overall survival.

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In situ detection of plasma exosomal microRNA for lung cancer diagnosis using duplex-specific nuclease and MoS2 nanosheets

The Analyst ◽

10.1039/d0an02193h ◽

2021 ◽

Author(s):

Zibo Gao ◽

Huijie Yuan ◽

Yanhua Mao ◽

Lihua Ding ◽

Clement Yaw Effah ◽

...

Keyword(s):

Lung Cancer ◽

Early Diagnosis ◽

Cancer Diagnosis ◽

Mos2 Nanosheets ◽

Diagnosis And Prognosis ◽

Lung Cancer Diagnosis ◽

In Situ Detection ◽

Exosomal Microrna ◽

The Ideal

MicroRNAs (miRNAs) encapsulated in tumor-derived exosomes are becoming the ideal biomarkers for the early diagnosis and prognosis of lung cancer. However, the accuracy and sensitivity are often hampered by the...

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Detection of K-ras gene mutation in bronchial aspirate of patients with lung carcinoma

Genetika ◽

10.2298/gensr0901069i ◽

2009 ◽

Vol 41 (1) ◽

pp. 69-80

Author(s):

Vesna Ilic ◽

Ilija Tomic ◽

Gordana Cvetkovic ◽

Radmila Bokun ◽

Zvonko Magic

Keyword(s):

Lung Cancer ◽

Early Diagnosis ◽

Malignant Tumors ◽

Molecular Genetic ◽

Diagnostic Procedures ◽

Cytological Analysis ◽

Ras Gene ◽

Lung Cancers ◽

Ras Genes ◽

Bronchial Aspirate

Lung cancer belongs to a group of tumors with bad prognosis resulting in limited therapeutic chances. It is the most common cause of cancer deaths and cancer-related deaths worldwide. Only 25-40% of lung cancers are considered resectable when a diagnosis is made and just 20% of patients have a confined disease at the time of surgery. That makes problem of early diagnosis of lung cancer one of the biggest challenges in clinical oncology. Our goal was to determine whether molecular genetic assays could augment conventional clinical and laboratory diagnostic procedures. Bronchoalveolar aspirate of patients with different histological types and stages of NSCLC were analyzed for presence of K-ras oncogene mutations (codons 12 and 13) and compared with cytological findings in the same samples. Mutations in codons 12 and 13 of K- and H-ras genes in bronchoalveolar aspirate of 53 patients (pts) were examined by polymerase chain reaction and SSCP analysis. Mutations in K-ras gene were identified in 18/53 (34%) specimens of bronchoalveolar aspirate, out of which 3/18 were adenocarcinomas, 11/18 squamous cell carcinoma, two were with anaplastic and two patients with chronical lung disease. The same samples were examined for presence of malignant cells by conventional cytological analysis. Normal cytological results were found in 6 samples of patients with malignant tumors out of which K-ras mutations were detected in 4 samples. A presence of mutated K-ras gene may prove useful as an adjunct to cytological analysis and also could serve as additional criteria for early diagnosis in patients with bronchogenic carcinoma.

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Racial Disparities in Lung Cancer Diagnosis and Treatment: A Single Center, Retrospective Study in Central Indiana

Proceedings of IMPRS ◽

10.18060/24660 ◽

2020 ◽

Vol 3 ◽

Author(s):

Andrew Killion ◽

Francesca Duncan ◽

Nawar Al Nasrallah ◽

Catherine Sears

Keyword(s):

Lung Cancer ◽

African Americans ◽

Racial Differences ◽

Cancer Diagnosis ◽

Private Insurance ◽

The United States ◽

Cancer Center ◽

Stage At Diagnosis ◽

Lung Cancer Diagnosis ◽

Incidence And Mortality

Background/Objective: Lung cancer is the second most common cancer and the leading cause of death from cancer in the United States. However, there is a disparity in incidence and mortality between African Americans and Caucasians. This study aims to analyze factors that could describe this difference, such as treatment, socioeconomic, or behavioral differences using information from an Indiana University Simon Cancer Center (IUSCC) lung cancer registry. We hypothesized that African Americans will have a higher lung cancer stage at diagnosis and mortality, associated with less timely, stage-appropriate treatment. Methods: Using data collected from patients diagnosed with lung cancer at IUSCC from 2000-2016, we compared racial differences in diagnoses and subsequent management. Patients were categorized by race and clinical stage at diagnosis. Further categorization by sex, vital status, age at diagnosis, time from diagnosis to treatment and death, tobacco use, surgery, chemotherapy, insurance coverage, and histology was performed. We determined the rates of surgery or chemotherapy by stage at diagnosis. Statistical analyses are by student t-test or 2-way ANOVA. Results: African Americans were younger than Caucasians at lung cancer diagnosis (average 63.4 vs. 61.2 years p-value < 0.001). African American race was associated with a longer time from diagnosis to treatment (36.4 vs. 32.1 days, p=0.023) and shorter time from diagnosis to death (475.1 vs. 623.7 days, p=0.001). The data suggests that African Americans have a later stage at diagnosis, are more likely to be uninsured and less likely to be covered by private insurance. The data suggests African Americans have a lower rate of surgery (Stages 1-3) and chemotherapy (Stages 3B and 4). Conclusion and Potential Impact: This data suggests racial differences in lung cancer diagnosis, treatment and outcomes. Future analyses will focus on multiple comparisons to determine possible impacts of socioeconomic and environmental factors on these outcomes at IUSCC and other university-affiliated health care systems.

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Factors affecting treatment in small cell and non-small cell lung cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.27_suppl.146 ◽

2019 ◽

Vol 37 (27_suppl) ◽

pp. 146-146

Author(s):

Phuong Ngo ◽

Christina M Pinkston ◽

Goetz H. Kloecker

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Stage Iv ◽

Small Cell ◽

Stage Iii ◽

Stage At Diagnosis ◽

Small Cell Lung ◽

Lung Cancer Patients ◽

Nsclc Patients

146 Background: Kentucky has the highest incidence of lung cancer death and despite improvements in treatment and survival, some small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) patients remain untreated. We looked at factors preventing these patients from receiving necessary treatment. Methods: Data was collected from the Kentucky Cancer Registry (KCR) for SCLC and NSCLC patients from 2012-2015 and included race, gender, age at diagnosis, treatment history, insurance and overall survival. Treatment included any combination of surgery, radiation, chemotherapy or immunotherapy. Patient demographics were summarized based on treatment status and derived odds ratio (OR) and 95% confidence intervals (CI) were reported. Significant associations were assessed at the p < 0.05 level. Results: KCR identified 2,992 SCLC and 13,975 NSCLC patients from 2012-2015. More NSCLC patients [3,608 (25.8%)] were untreated than SCLC patients [621 (20.8%), p < 0.001], and untreated patients overall were more likely to be older, have more comorbidities (SCLC only), and have Medicare, Medicaid or no insurance. Stage at diagnosis was also a factor but differed based on histology. NSCLC stage III and stage IV patients had higher odds of being untreated compared to stage I (Stage III OR: 2.91, 95% CI: 2.57-3.28; Stage IV OR: 4.82, 95% CI: 4.29-5.41) where these odds in SCLC patients were non-significant (Stage III OR: 0.94, 95% CI: 0.56-1.55) or lower (Stage IV OR: 1.61, 95% CI: 1.01-2.55). SCLC patients also had lower odds of delayed treatment (defined as > 4 weeks to treatment) in stage III and stage IV compared to stage I (Stage III OR: 0.33, 95% CI: 0.23-0.48; Stage IV OR: 0.27, 95% CI: 0.20-0.38). Conclusions: This study shows an overall significant number of untreated lung cancer patients with treatment being strongly associated with insurance status, histology and stage at diagnosis. SCLC patients are more likely to be treated than NSCLC, and advanced stage is less a factor in treating SCLC than NSCLC. The difference may be due to the more aggressive nature of SCLC with physicians feeling more urgency to treat SCLC given its rapid progression and chemotherapy sensitivity compared to NSCLC.

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P2.01-76 The Impact of Concordance with a Lung Cancer Diagnosis Pathway Guideline on Treatment Access in Patients with Stage IV Lung Cancer

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2018.08.1130 ◽

2018 ◽

Vol 13 (10) ◽

pp. S694

Author(s):

A. Pattison ◽

L. Jeagal ◽

J. Yeung ◽

A. Pierre ◽

L. Donahoe ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Diagnosis ◽

Stage Iv ◽

Treatment Access ◽

Lung Cancer Diagnosis ◽

Stage Iv Lung Cancer ◽

The Impact

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Robotic System for Catheter Navigation during Medical Procedures

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.896.211 ◽

2020 ◽

Vol 896 ◽

pp. 211-217 ◽

Cited By ~ 1

Author(s):

Lucian Gheorghe Gruionu ◽

Catalin Constantinescu ◽

Andreea Iacob ◽

Gabriel Gruionu

Keyword(s):

Lung Cancer ◽

Early Diagnosis ◽

Guide Wire ◽

Survival Rates ◽

Stage Iv ◽

Force Sensor ◽

Bronchial Tree ◽

Robotic System ◽

Small Airways ◽

Airway Model

Lung cancer is the most common cancer globally with over 2 million new cases diagnosed every year. Fortunately, if caught early, the likelihood of survival is greatly improved. If diagnosed in Stage I, survival rates are >75% over 5 years, vs. just 1% if diagnosed in Stage IV. Early diagnosis requires finding and sampling (biopsy) small, peripheral nodules that are located in the parenchima of the lung and predominately outside small airways. Currently, for early diagnosis a bronchoscope is inserted into the lung airway but due to large size it cannot reach the small airways. Therefore, the doctor has to advance a sharp biopsy needle blindly from the tip of the bronchoscope and into the lung tissue in the approximate direction of the nodule. This blind procedure has low accuracy and carries a high risk of misdiagnosis. Currently, to improve the accuracy, real time x-ray (fluoroscopy) is use which causes exposure of the patient and physician to harmful radiation. Computer and image assisted surgery and medical robotics present viable solutions but are not optimal at present. The scope of our research was to develop a robotic solution for increased precision and accuracy of early diagnosis and treatment of lung cancer, to increase procedure success rate, decrease patient radiation and stress exposure, and reduce the procedure cost. For this purpose, we developed an advanced prototype of a robotic system which is small in size, easy to use and effective. To demonstrate its effectiveness in navigating to peripheral small size lung cancer lesions, we performed laboratory tests or a realistic lung airway model. The preliminary tests of a novel medical robot using a complex lung airway model proved that our catheter driving robotic system is working as designed and allows navigation, through a complex 3D channels structure like the bronchial tree, in both manipulator and robotic modes without fluoroscopy scanning. The robotic system is more precise and stable, and can avoid patient injury and instrument damage due to accidental impact with the airway wall. Because it could be controlled from a different room via the software platform, using this robotic system can drastically reduce radiation exposure of the patient and totally avoid the exposure of the doctor. Another benefit of the proposed robotic system is that it uses currently available catheters in which a reusable electromagnetic guide wire is temporarily inserted to guide the tip of the catheter towards hard to reach targets. After the target is confirmed, the sensor can be retracted and the catheter can be used for its routine function such as biopsy collection. Future development will include placement of a force sensor at the tip of the catheter to “feel” the wall and adapt the speed of insertion in order to avoid wall damage and an improved algorithm to increase the speed in the automatic mode.

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An Ontology Based Expert System for Lung Cancer : OBESLC

International Journal of Engineering and Advanced Technology - Regular Issue ◽

10.35940/ijeat.b5116.129219 ◽

2019 ◽

Vol 9 (2) ◽

pp. 4622-4626

Keyword(s):

Lung Cancer ◽

Expert System ◽

Semantic Web ◽

Query Language ◽

Cancer Society ◽

Cancer Disease ◽

Recurrent Cancer ◽

Lung Cancer Diagnosis ◽

Description Framework ◽

Machine Readable

Lung Cancer is the second most recurrent cancer in both men and women and which is the leading cause of cancer death worldwide. The American cancer Society (ACS) in US estimates nearly 228,150 new cases of lung cancer and 142,670 deaths from lung cancer for the year 2019. This paper proposes to build an ontology based expert system to diagnose Lung Cancer Disease and to identify the stage of Lung Cancer. Ontology is defined as a specification of conceptualization and describes knowledge about any domain in the form of concepts and relationships among them. It is a framework for representing shareable and reusable knowledge across a domain. The advantage of using ontology for knowledge representation of a particular domain is they are machine readable. We designed a System named OBESLC (Ontology Based Expert System for Lung Cancer) for lung cancer diagnosis, in that to construct an ontology we make use of Ontology Web Language (OWL) and Resource Description Framework (RDF) .The design of this system depends on knowledge about patient’s symptoms and the state of lung nodules to build knowledge base of Lung Cancer Disease. We verified our ontology OBESLC by querying it using SPARQL query language, a popular query language for extracting required information from Semantic web. We validate our ontology by developing reasoning rules using semantic Web Rule Language (SWRL).To provide the user interface, we implemented our approach in java using Jena API and Eclipse Editor.

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