Lung Cancer at St. Anthony’s Hospital 2000-2009 with Comparisons with the National Cancer Data Base

Lung cancer is the second most common cancer seen at St. Anthony’s (SAH) and accounted for 16% of analytic cases in 2009. Nationally lung cancer accounted for 14.8% of all cases. The incidence of this disease has been stable over the last ten years as noted in figure 1.

2

Analytic Lung Cancer Cases at St. Anthony's Hospital by Year

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2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Figure 1

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Small Cell NSCL Squam Adeno Carc NOS Other

Histology

Small cell carcinoma (SCL) accounted for 14% of the histological types and Non-Small cell (NSCL) for 86% as show in figure 2. In the NCDB NSCL accounted for 84% and SCL 16%.

Figure 2

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Age Distribution

SAH

NCDB

The race and age distribution are as noted in figures 3 and 4 and are similar to the distribution from the corresponding National Cancer Data Base (NCDB).

Figure 3

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Race Distribution

SAH

NCDB

Figure 4

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Stage I Stage II Stage III Stage IV

Stage Comparisons NSCL

SAH

NCDB

Stage distribution and comparisons are as noted. Patient with lung cancer are rarely diagnosed in early stages and for NSCL only 24% were stage I/II and for SCL only 13%. See figures 5 and 6

Figure 5

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Stage I Stage II Stage III Stage IV

Stage Comparisons for SCL

SAH

NCDB

Figure 6

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45%

Stage I Stage II Stage III Stage IV

Survival Comparisons NSCL

SAH

NCDB

Survival is similar to NCDB (figures 7 and 8) and reflects the poor outcome of this cancer.

Figure 7

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Stage I Stage II Stage III Stage IV

Survival Comparisons for SCL

SAH

NCDB

Figure 8

The frequency of smoking has been declining for many years and SAH became a completely smoke free campus in 2010. We looked to see if the percent of lung cancer patients identified as smokers has changed over the last ten years and if this affected their prognosis.

      NSCL     SCL  

2000-05 2009 2000-05 2009

Smoker Male 43% 39% 50% 46%

Female 41% 43% 44% 33%

Non-smoker Male 7% 7% 2% 4%

    Female 9% 12%   4% 17%

Smoking Distribution by Gender and Histology

During the period 2000-2005 16% of the NSCL patients were non-smokers and this number increased to 19% in 2009. With SCL 6% were non-smokers during 2000-2005 and this number rose to 21% in 2009. The details by gender and histology are as noted in figure 9.

Figure 9

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NSCL SCL

5 Year Relative Survival by Histology and Smoking History

Smoker

Non-smoker

The outcome for non-smokers was superior to smokers. The 5 year relative survival for NSCL rose from 10.4% (smokers) to 16.3% (non-smokers). For SCL patients the survival was also much better, 5.13% (smokers) and 37.2% (non-smokers), see figure 10.

Figure 10