Factors associated with diagnosis of stages I and II lung cancer: a multivariate analysis
DOI:
https://doi.org/10.11606/s1518-8787.2021055003345Keywords:
Lung Neoplasms, diagnosis, Early Detection of Cancer, Survival Analysis, Socioeconomic Factors, Healthcare DisparitiesAbstract
OBJECTIVE To present the overall survival rate for lung cancer and identify the factors associated with early diagnosis of stage I and II lung cancer. METHODS This is a retrospective cohort study including individuals diagnosed with lung cancer, from January 2009 to December 2017, according to the cancer registry at UMass Memorial Medical Center. Five-year overall survival and its associated factors were identified by Kaplan–Meier curves and Cox’s proportional hazards model. Factors associated with diagnosing clinical stage I and II lung cancer were identified by bivariate and multivariate backward stepwise logistic regression (Log-likelihood ratio (LR)) at 95% confidence interval (CI). RESULTS The study was conducted with data on 2730 individuals aged 67.9 years on average, 51.5% of whom female, 92.3% white, and 6.6% never smoked. Five-year overall survival was 21%. Individuals diagnosed with early-stage disease had a 43% five-year survival rate compared to 8% for those diagnosed at late stages. Stage at diagnosis was the main factor associated with overall survival [HR = 4.08 (95%CI: 3.62–4.59)]. Factors associated with early diagnosis included patients older than 68 years [OR = 1.23 (95%CI: 1.04–1.45)], of the female gender [OR = 1.47 (95%CI: 1.24–1.73)], white [OR = 1.63 (95%CI: 1.16–2.30)], and never-smokers [OR = 1.37 (95%CI: 1.01–1.86)]; as well as tumors affecting the upper lobe [OR = 1.46 (95%CI: 1.24–1.73)]; adenocarcinoma [OR = 1.43 (95%CI: 1.21–1.69)]; and diagnosis after 2014 [OR = 1.61 (95%CI: 1.37–1.90)]. CONCLUSIONS Stage at diagnosis was the most decisive predictor for survival. Non-white and male individuals were more likely to be diagnosed at a late stage. Thus, promoting lung cancer early diagnosis by improving access to health care is vital to enhance overall survival for individuals with lung cancer.
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Copyright (c) 2021 Isabel Cristina Martins Emmerick, Anupama Singh, Maggie Powers, Feiran Lou, Poliana Lin, Mark Maxfield, Karl Uy
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