title: Incidence and survival of non-small cell lung cancer in Shanghai: a population-based cohort study.
abstract: OBJECTIVE
  Large population-based studies on the incidence and outcome of non-small cell lung cancer (NSCLC) are lacking in mainland China. This study aimed to investigate the NSCLC incidence, demographic features and survival as well as factors affecting survival of patients with NSCLC in Shanghai.
  
  
  METHODS
  Prospective observational cohort study.
  
  
  METHODS
  Baseline information was collected from Shanghai Health Information Network, which is based on the Health Information Systems from all the comprehensive hospitals and specialist hospitals qualified for cancer diagnosis in the Shanghai metropolitan area.
  
  
  METHODS
  All NSCLC cases identified from the database between 2011 and 2013 were recruited (15,020 patients).
  
  
  RESULTS
  The crude and age-adjusted incidences of NSCLC were 54.20 per 100,000 people (55.90 per 100,000 for men, 52.39 per 100,000 for women) and 39.05 per 100,000 people (41.43 per 100,000 for men and 37.13 per 100,000 for women), respectively. The median survival time was 22.7 months (95% CI 21.8 to 24.2 months) with an overall 1-year survival rate of 71.8% (95% CI 69.8% to 73.8%). The 1-year survival rate was 96.5% (95% CI 94.0% to 98.6%) in patients with stage I NSCLC, 89.1% (95% CI 83.3% to 94.9%) in patients with stage II NSCLC, 78.8% (95% CI 74.1% to 83.5%) in patients with stage IIIa NSCLC and 58.9% (95% CI 56.1% to 61.7%) in patients with stage IIIb/IV NSCLC. Multivariate analysis showed surgical resection (HR=0.607, 95% CI 0.511 to 0.722) and chemotherapy (HR=0.838, 95% CI 0.709 to 0.991) significantly improved survival. Factors associated with poor survival included older age, male sex, larger tumour size, lymph node metastasis, distant metastasis and squamous cell carcinoma.
  
  
  CONCLUSIONS
  A higher incidence and better survival rates for patients with NSCLC were identified when compared with previously published studies, which may provide evidence on the incidence and survival of NSCLC in China.
authors.affiliation: Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.
authors.forename: Heng
authors.initials: H
authors.lastname: Fan
authors.affiliation: Information Centre, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China.
authors.forename: Zhen-Yi
authors.initials: ZY
authors.lastname: Shao
authors.affiliation: Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Xiao
authors.affiliation: Information Centre, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China.
authors.forename: Zhi-Hui
authors.initials: ZH
authors.lastname: Xie
authors.affiliation: Information Centre, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Chen
authors.affiliation: Information Centre, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Xie
authors.affiliation: Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.
authors.forename: Guo-You
authors.initials: GY
authors.lastname: Qin
authors.affiliation: Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.
authors.forename: Nai-Qing
authors.initials: NQ
authors.lastname: Zhao
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012737:Sex Factors; D015996:Survival Rate
keywords: CHEMOTHERAPY; SURGERY