Survival among Never-Smokers with Lung Cancer in the Cancer Care Outcomes Research and Surveillance Study
| Autor: | Xiangyan Xu, Michael K. Gould, Christelle Clément-Duchêne, Ellen T. Chang, Shannon Stock, Heather A. Wakelee, Dee W. West, Scarlett Lin Gomez |
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| Rok vydání: | 2016 |
| Předmět: |
Male
0301 basic medicine Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms Adolescent Adenocarcinoma 03 medical and health sciences Sex Factors 0302 clinical medicine Risk Factors Internal medicine Outcome Assessment Health Care Epidemiology of cancer Ethnicity medicine Humans Prospective Studies Prospective cohort study Lung cancer Original Research Proportional Hazards Models Aged 80 and over business.industry Proportional hazards model Medical record Smoking Infant Cancer Middle Aged Prognosis Former Smoker medicine.disease United States respiratory tract diseases 030104 developmental biology Socioeconomic Factors 030220 oncology & carcinogenesis behavior and behavior mechanisms Physical therapy Female Outcomes research business |
| Zdroj: | Annals of the American Thoracic Society. 13:58-66 |
| ISSN: | 2325-6621 2329-6933 |
| DOI: | 10.1513/annalsats.201504-241oc |
| Popis: | Differences in patient characteristics and outcomes have been observed among current, former, and never-smokers with lung cancer, but most prior studies included few never-smokers and were not prospective.We used data from a large, prospective study of lung cancer care and outcomes in the United States to compare characteristics of never-smokers and smokers with lung cancer and to examine survival among the never-smokers.Smoking status at diagnosis was determined by self-report and survival was determined from medical records and cancer registries, with follow-up through June 2010 or later. Cox regression was used to examine the association between smoking and survival, and to identify predictors of survival among never-smokers.Among 3,410 patients with lung cancer diagnosed between September 1, 2003 and October 14, 2005 who completed a baseline patient survey, there were 274 never-smokers (8%), 1,612 former smokers (47%), 1,496 current smokers or smokers who quit recently (44%), and 28 with missing information about smoking status (1%). Never-smokers appeared more likely than former and current/recent smokers to be female and of Asian or Hispanic race/ethnicity, and to have adenocarcinoma histology, fewer comorbidities, private insurance, and higher income and education. Compared with never-smokers, the adjusted hazard of death from any cause was 29% higher among former smokers (hazard ratio, 1.29; 95% confidence interval, 1.08-1.55), and 39% higher among current/recent smokers (hazard ratio, 1.39; 95% confidence interval, 1.16-1.67). Factors predicting worse overall survival among never-smokers included Hispanic ethnicity, severe comorbidity, undifferentiated histology, and regional or distant stage. Never-smoking Hispanics appeared more likely to have regional or advanced disease at diagnosis and less likely to undergo surgical resection, although these differences were not statistically significant.Never-smokers with lung cancer are more likely than ever-smokers to be female, Asian or Hispanic, and more advantaged socioeconomically, suggesting possible etiologic differences in lung cancer by smoking status. Among never-smokers, Hispanics with lung cancer had worse survival than non-Hispanic whites. |
| Databáze: | OpenAIRE |
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