title: Steadily improving survival in lung cancer.
abstract: BACKGROUND
  National data demonstrate minimal improvement in survival for patients diagnosed with lung cancer despite a number of apparent advances during the past 3 decades. We wished to know how demographic characteristics, staging, therapy, and survival have changed over time for patients with lung cancer who were accessioned to the cancer registry of a large community hospital in southern California.
  
  
  METHODS
  Clinical features and survival data were collected on patients diagnosed during each of the successive 6-year eras of 1986 to 1991 (n = 812), 1992 to 1997 (n = 1072), 1998 to 2003 (n = 1209), and 2004 to 2009 (n = 1365).
  
  
  RESULTS
  Median survival improved from 11 to 13 to 16 to 26 months and overall 5-year survival steadily improved from 16.5% to 19.1% to 24.0% to 31.1%. The proportion of patients with localized disease at diagnosis increased from 18.4% to 24.1% to 24.9% to 31.6%. Improvements in relative survival were much greater than have occurred nationally. Other obvious trends over time were increasing age of patients, increasing proportions with diagnoses of adenocarcinoma with concomitant decreases in squamous cell and small cell histologies, and decreases in the proportion of large cell carcinoma with reciprocal increases in neuroendocrine diagnoses. The use of chemotherapy for patients with local disease tripled in the most recent era.
  
  
  CONCLUSIONS
  Survival has steadily improved for patients in this community who were diagnosed with lung cancer. The explanations for this improvement are multifactorial, but include earlier stage at diagnosis, decreases in histologic types associated with active smoking, and increased use of systemic therapies.
authors.affiliation: Hoag Institute for Research and Education; Hoag Family Cancer Institute, One Hoag Drive Building 41, Newport Beach, California, 92663. Electronic address: robert.dillman55@gmail.com.
authors.forename: Robert O
authors.initials: RO
authors.lastname: Dillman
authors.affiliation: Hoag Institute for Research and Education.
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: McClure
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002140:California; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: Lung cancer histologies; Lung cancer stages; Patient characteristics; Survival; Treatment