title: Undertreatment trend in elderly lung cancer patients in Brazil.
abstract: OBJECTIVE
  Elderly patients with lung cancer tend to be undertreated in comparison to younger patients. The objective of this study is to compare treatment modalities offered to lung cancer patients from 70 years of age or more with patients under 70.
  
  
  METHODS
  For this study, an analytical cross-sectional epidemiological study conducted with data from the Brazilian hospital-based cancer registries between the years 2000 and 2011. In addition, odds ratios (OR) were calculated, with a 95% confidence intervals (95% CI), in conjunction with the construction of a logistic regression model.
  
  
  RESULTS
  By analyzing the records of 40,403 patients with lung cancer, we found that overall, patients from 70 years of age or more corresponded to 28.6% of the study population. Squamous cell carcinoma was the most common histological type among patients ≥70 years of age, whereas adenocarcinoma was the more prevalent type among younger patients. In comparison to younger patients, the older ones were treated less often (OR = 0.57; 95% CI: 0.52-0.62). Moreover, older patients were less likely to undergo surgery (OR = 0.69; 95% CI: 0.64-0.75), radiotherapy (OR = 0.86; 95% CI: 0.81-0.92), chemotherapy (OR = 0.61; 95% CI: 0.57-0.64), or an association of two or more treatment modalities (OR = 0.58; 95% CI: 0.54-0.62).
  
  
  CONCLUSIONS
  The study finds that Brazilian lung cancer patients ≥70 years of age are often undertreated and higher percentage of early death rates as compared to patients under 70. In regard to treatment, age alone should not determine whether patients with lung cancer are treated or not.
authors.affiliation: Department of Oncology, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil.
authors.forename: Guilherme Jorge
authors.initials: GJ
authors.lastname: Costa
authors.affiliation: Hospital Infection Control Committee, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Pernambuco, Brazil.
authors.forename: Maria Júlia Gonçalves
authors.initials: MJG
authors.lastname: de Mello
authors.affiliation: Brazilian Ministry of Health, National Clinical Cancer Research Network (RNPCC), Rio de Janeiro, RJ, Brazil.
authors.forename: Carlos Gil
authors.initials: CG
authors.lastname: Ferreira
authors.affiliation: Clinical Research Division, Brazilian National Cancer Institute (INCA), Rua André Cavalcanti, 37, 2° andar, Rio de Janeiro, RJ, 20231-050, Brazil. lthuler@gmail.com.
authors.forename: Luiz Claudio Santos
authors.initials: LCS
authors.lastname: Thuler
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology / Q000532:radiotherapy; D017024:Chemotherapy, Adjuvant; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D012042:Registries
keywords: Brazil; Elderly patients; Lung cancer; Undertreatment