title: Initial medical attention on patients with early-stage non-small cell lung cancer.
abstract: BACKGROUND
  Detection of early stage non-small cell lung cancer (NSCLC) is commonly believed to be incidental. Understanding the reasons that caused initial detection of these patients is important for early diagnosis. However, these reasons are not well studied.
  
  
  METHODS
  We retrospectively reviewed medical records of patients diagnosed with stage I or II NSCLC between 2000 and 2009 at UT MD Anderson Cancer Center. Information on suggestive LC-symptoms or other reasons that caused detection were extracted from patients' medical records. We applied univariate and multivariate analyses to evaluate the association of suggestive LC-symptoms with tumor size and patient survival.
  
  
  RESULTS
  Of the 1396 early stage LC patients, 733 (52.5%) presented with suggestive LC-symptoms as chief complaint. 347 (24.9%) and 287 (20.6%) were diagnosed because of regular check-ups and evaluations for other diseases, respectively. The proportion of suggestive LC-symptom-caused detection had a linear relationship with the tumor size (correlation 0.96; with p<.0001). After age, gender, race, smoking status, therapy, and stage adjustment, the symptom-caused detection showed no significant difference in overall and LC-specific survival when compared with the other (non-symptom-caused) detection.
  
  
  CONCLUSIONS
  Symptoms suggestive of LC are the number one reason that led to detection in early NSCLC. They were also associated with tumor size at diagnosis, suggesting early stage LC patients are developing symptoms. Presence of symptoms in early stages did not compromise survival. A symptom-based alerting system or guidelines may be worth of further study to benefit NSCLC high risk individuals.
authors.affiliation: Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, United States of America. cnxingchen@gmail.com
authors.forename: Xing
authors.initials: X
authors.lastname: Chen
authors.forename: Ivan P
authors.initials: IP
authors.lastname: Gorlov
authors.forename: Jun
authors.initials: J
authors.lastname: Ying
authors.forename: Kelly W
authors.initials: KW
authors.lastname: Merriman
authors.forename: Marek
authors.initials: M
authors.lastname: Kimmel
authors.forename: Charles
authors.initials: C
authors.lastname: Lu
authors.forename: Cielito C
authors.initials: CC
authors.lastname: Reyes-Gibby
authors.forename: Olga Y
authors.initials: OY
authors.lastname: Gorlova
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D047368:Tumor Burden