Ethnic disparities in conditional survival of patients with non-small cell lung cancer

J Thorac Oncol. 2007 Mar;2(3):180-90. doi: 10.1097/JTO.0b013e318031cd4e.

Abstract

Purpose: Conditional survival (CS) is an accurate estimate of survival probability for patients who have already survived at least 1 year after diagnosis. The purpose of this study was to determine whether ethnicity plays a role in 5-year CS rates for patients with non-small cell lung cancer (NSCLC).

Materials and methods: Using the Surveillance, Epidemiology, and End Results database, we analyzed 96,480 patients with NSCLC diagnosed between 1988 and 1995. Patients were divided into five ethnic groups: White (non-Hispanic), Hispanic, African American, Asian/Pacific Islander, and Native American/Alaskan. Using the life table method, we computed observed 5-year CS rates for patients who had already survived up to 5 years after diagnosis. Results were analyzed by stage, age, sex, and histology.

Results: In general, 5-year CS rates increase for all ethnicities as time from diagnosis increases, but African Americans continued to have lower CS rates compared with other ethnic groups, even up to 5 years from diagnosis. When analyzed by stage, Hispanics with stage IV disease showed the greatest improvement in CS rate, increasing to 73% at 5 years from diagnosis. Among patients older than 70 years, African Americans had the lowest CS at 5 years--only 28%, compared with 40% to 47% for other groups. When analyzed by histology, Hispanics with large cell carcinoma had the worst CS rate (35% at 5 years).

Conclusion: For patients with NSCLC surviving a period of time after diagnosis, 5-year CS rates vary by ethnicity. CS can provide accurate prognostic information for patients with NSCLC who have already survived several years after diagnosis.

MeSH terms

  • Aged
  • Carcinoma, Non-Small-Cell Lung / ethnology*
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Female
  • Humans
  • Lung Neoplasms / ethnology*
  • Lung Neoplasms / mortality
  • Male
  • SEER Program
  • Survival Analysis
  • United States / epidemiology