title: Key factors influencing lung cancer survival in northern Italy.
abstract: OBJECTIVE
  Lung cancer is a major cause of cancer death worldwide. The aims of this study were to analyze presentation, treatment and survival for lung cancer in northern Italy, and identify factors influencing survival.
  
  
  METHODS
  A total of 1180 lung cancer cases diagnosed in four north Italian cancer registries (Biella, Modena, Reggio Emilia, Romagna) in 2003-2005 were analyzed. Information on morphology, stage, diagnostic examinations, chemotherapy, radiotherapy, and surgical treatment was collected from clinical records. Three-year relative survival and relative excess risks of death were estimated.
  
  
  RESULTS
  Overall, 10% of cases were stage I, 50% stage IV, and 12% stage unknown. Romagna - where sophisticated diagnostic examinations were performed more often - had proportionately more microscopically verified cases and resected cases than Biella. Romagna had also high proportions of cases given chemotherapy and radiotherapy. Three-year survival was 14%, range 10% (Biella) to 19% (Romagna); 69% for stage I, 3% for stage IV. Stage I survival was higher in Romagna (82%) than Reggio Emilia and Biella (60-61%) but for operated stage I cases, survival was similar (88%) in Romagna and Biella. The fully adjusted model showed a higher risk of death in Biella (1.23, 95%CI 1.02-1.48) than Modena (reference).
  
  
  CONCLUSIONS
  Stage and surgery are key factors influencing survival. Centralizing lung cancer treatment to improve diagnostic work-up may improve outcomes.
authors.affiliation: Statistical, Quality and Clinical Studies Unit, IRCCS Arcispedale Santa Maria Nuova, Viale Umberto I 50, 42123 Reggio Emilia, Italy. Lucia.Mangone@asmn.re.it
authors.forename: Lucia
authors.initials: L
authors.lastname: Mangone
authors.forename: Pamela
authors.initials: P
authors.lastname: Minicozzi
authors.forename: Massimo
authors.initials: M
authors.lastname: Vicentini
authors.forename: Adriano
authors.initials: A
authors.lastname: Giacomin
authors.forename: Adele
authors.initials: A
authors.lastname: Caldarella
authors.forename: Claudia
authors.initials: C
authors.lastname: Cirilli
authors.forename: Fabio
authors.initials: F
authors.lastname: Falcini
authors.forename: Paolo
authors.initials: P
authors.lastname: Giorgi Rossi
authors.forename: Milena
authors.initials: M
authors.lastname: Sant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016019:Survival Analysis; D055815:Young Adult