Histology-related variation in the treatment and survival of patients with lung carcinoma in Canada.
OBJECTIVE
The aim of the study was to examine histologic differences in lung cancer treatment and survival, and to define recent survival trends in Ottawa, Canada.


METHODS
From 1994 to 2000, 3,237 patients with invasive lung cancer were registered at the Ottawa Regional Cancer Centre (ORCC) and were followed up to 31 December 2001. Five-year relative survival rates (RSRs) and relative excess risks (RERs) of dying were calculated by stage and dominant initial treatment modalities for major cellular histologies using a relative survival model.


RESULTS
The overall 5-year survival rate was 14%, and female patients had significantly better survival. Patients with stage I and II non-small cell lung cancer (NSCLC) who were treated by surgery alone were more likely to survive (5-year RSRs were 72 and 48%, respectively) than those who received other treatments. Patients with stage III NSCLC had a 5-year survival rate of 9% after chemotherapy plus radiotherapy, whereas stage IV patients who received only chemotherapy had better survival for up to 2 years than patients with other treatments. In cases of limited-stage small cell lung cancer (SCLC), survival was better for patients who received chemotherapy plus radiotherapy than for those who received only chemotherapy.


CONCLUSIONS
The relatively superior survival of surgical patients with stage I NSCLC implies that a considerable number of patients have the potential to be treated successfully. The overall poor survival of lung cancer patients suggests a need for more national public health emphasis on lung cancer prevention, improved screening and early diagnosis, and better treatment.
Xie
Lin
L
Surveillance and Risk Assessment Division, Center for Chronic Disease Prevention and Control, Population and Public Health Branch, Health Canada, 120 Colonnade Road, Address Locator 6702A, Ottawa, Ont., Canada K1A 0K9.
Ugnat
Anne-Marie
AM
Morriss
Judy
J
Semenciw
Robert
R
Mao
Yang
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis