| Revue: | Revista de saude publica |
| Base de datos: | |
| Número de sistema: | 000535871 |
| ISSN: | 0034-8910 |
| Autores: | Emmerick, Isabel Cristina Martins1 Singh, Anupama1 Powers, Maggie1 Lou, Feiran1 Lin, Poliana1 Maxfield, Mark1 Uy, Karl1 |
| Instituciones: | 1University of Massachusetts, Medical School, Worcester. Estados Unidos |
| Año: | 2021 |
| Volumen: | 55 |
| País: | Brasil |
| Idioma: | Inglés |
| Resumen en inglés | 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. |
| Keyword: | Lung Neoplasms, diagnosis, Early Detection of Cancer, Survival Analysis, Socioeconomic Factors, Healthcare Disparities |
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