Details of the analysis Incidence, prevalence of NSCLC in the United States

A recent analysis provides updated data on non-small cell lung cancer in the United States.

A cross-sectional epidemiological analysis in the United States found an overall decrease in the incidence of non-small cell lung cancer (NSCLC) between 2010 and 2017 in age and sex subgroups, but showed an increased incidence stage I NSCLC at the time of diagnosis. The latter result potentially reflects a better assessment of accidental nodules, the researchers wrote. The results were published in JAMA Oncology.

Globally, lung cancer is the leading cause of cancer-related deaths, while NSCLC accounts for about 84% of all lung cancers, according to the researchers.

Despite the disease’s poor prognosis, treatment has changed dramatically over the past decade, in part thanks to broader screening for lung cancer and improved radiotherapy techniques.

In an effort to elucidate the most recent estimates of the prevalence, incidence, and survival of patients with NSCLC, the researchers evaluated anonymized data from the United States Cancer Statistics database comprising the Surveillance, Epidemiology, and End Results program (SEER-18) and the National Cancer Registries Program (NPCR) program.

All people aged 18 and over with NSCLC diagnosed in 2010 were included in the current analysis, while “the annual incidence per 100,000 people was age-adjusted to the standard population. of the United States of 2000, ”the authors wrote. Additionally, “a crude estimate of annual prevalence per 100,000 people was defined as the annual incidence plus all patients who were diagnosed with NSCLC in previous years (the earliest year was 2000 when SEER -18 has been established). “

Data showed that between 2010 and 2017, 1.28 million new cases of NSCLC were reported. Fifty-three percent of the patients were male and 67% were at least 65 years old.

The analyzes revealed:

  • From 2010 to 2017, the incidence of NSCLC per 100,000 decreased from 46.4 to 40.9 overall (age
  • The incidences of stage II, IIIA and IIIB NSCLC were stable; stage IV decreased slightly from 21.7 to 19.6; and the incidence of stage I decreased from 10.8 to 13.2
  • From 2010 to 2016, the prevalence of NSCLC per 100,000 increased from 175.3 to 198.3 (national projection of SEER-18)
  • Prevalence increased in younger patients (77.5 to 87.9) but decreased in older patients (825.1 to 812.4)
  • 26.4% of patients survived 5 years, which is higher than previously reported
  • The proportion of stage I NSCLC treated with radiation therapy as the sole initial treatment increased markedly from 14.7% in 2010 to 25.7% in 2016
  • Patients with stage IV NSCLC aged 65 years or older were the most likely to be untreated (38.3%)

In the SEER-NPCR database, adenocarcinoma was the most common histologic finding of NSCLC, followed by squamous cell.

Researchers hypothesized that the increased incidence of stage I NSCLC may be due to increased screening rates following the publication of the National Lung Screening Trial in 2011 and the US Preventive Services Task. Force in 2013.

However, the overall decrease in the incidence of NSCLC could be attributed to the tobacco control programs implemented over the past decade.

“Unlike the overall decline in incidence, but consistent with improved survival, the overall prevalence of NSCLC increased from 2010 to 2016, suggesting that patients generally live longer after diagnosis,” the authors added. .

The retrospective nature of the data included in the analysis and the fact that the SEER-18 database does not have a nationwide sample mark the limitations of the current study.

“Despite the availability of effective treatments, patients 65 years of age or older with stage IV NSCLC have the lowest 5-year survival, which may be at least in part due to under-treatment. The reasons for this should be further investigated, ”the researchers concluded.

Reference

Ganti AK, Klein AB, Cotarla I, Seal B, Chou E. Update on incidence, prevalence, survival and initial treatment in patients with non-small cell lung cancer in the United States . JAMA Oncol. Published online October 21, 2021. doi: 10.1001 / jamaoncol.2021.4932


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