Smoking status and the association between patient-level factors and survival among lung cancer patients.

Autor:	Carroll NM; Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA., Burnett-Hartman AN; Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA.; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA., Rendle KA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Neslund-Dudas CM; Henry Ford Health and Henry Ford Cancer Institute, Detroit, MI, USA., Greenlee RT; Marshfield Clinic Research Institute, Marshfield, WI, USA., Honda SA; Hawaii Permanente Medical Group, Center for Integrated Healthcare Research, Kaiser Permanente Hawaii, Honolulu, HI, USA., Vachani A; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Ritzwoller DP; Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA.
Jazyk:	angličtina
Zdroj:	Journal of the National Cancer Institute [J Natl Cancer Inst] 2023 Aug 08; Vol. 115 (8), pp. 937-948.
DOI:	10.1093/jnci/djad098
Abstrakt:	Background: Declines in the prevalence of cigarette smoking, advances in targeted therapies, and implementation of lung cancer screening have changed the clinical landscape for lung cancer. The proportion of lung cancer deaths is increasing in those who have never smoked cigarettes. To better understand contemporary patterns in survival among patients with lung cancer, a comprehensive evaluation of factors associated with survival, including differential associations by smoking status, is needed. Methods: Patients diagnosed with lung cancer between January 1, 2010, and September 30, 2019, were identified. We estimated all-cause and lung cancer-specific median, 5-year, and multivariable restricted mean survival time (RMST) to identify demographic, socioeconomic, and clinical factors associated with survival, overall and stratified by smoking status (never, former, and current). Results: Analyses included 6813 patients with lung cancer: 13.9% never smoked, 54.2% formerly smoked, and 31.9% currently smoked. All-cause RMST through 5 years for those who never, formerly, and currently smoked was 32.1, 25.9, and 23.3 months, respectively. Lung cancer-specific RMST was 36.3 months, 30.3 months, and 26.0 months, respectively. Across most models, female sex, younger age, higher socioeconomic measures, first-course surgery, histology, and body mass index were positively associated, and higher stage was inversely associated with survival. Relative to White patients, Black patients had increased survival among those who formerly smoked. Conclusions: We identify actionable factors associated with survival between those who never, formerly, and currently smoked cigarettes. These findings illuminate opportunities to address underlying mechanisms driving lung cancer progression, including use of first-course treatment, and enhanced implementation of tailored smoking cessation interventions for individuals diagnosed with cancer. (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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