Decreasing incidence of lung cancer and unfavorable survival prognosis: study of temporal trends in burden and survival by histology
Lung cancer (LC) is the fourth most incident cancer in Argentina and the leading cause of cancer-related death. Survival rates are low. Sex, age, and histology play a significant role in the burden and temporal trends. We analyzed the incidence and survival of LC in Córdoba, Argentina, from 2004 to...
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2023
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/42809 |
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I10-R327-article-42809 |
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Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
Joinpoint Regression Cox Regression Survival Regresión Joinpoint Regresión de Cox Supervivencia |
| spellingShingle |
Joinpoint Regression Cox Regression Survival Regresión Joinpoint Regresión de Cox Supervivencia Canale , MG Muñoz, FL Díaz , MP Decreasing incidence of lung cancer and unfavorable survival prognosis: study of temporal trends in burden and survival by histology |
| topic_facet |
Joinpoint Regression Cox Regression Survival Regresión Joinpoint Regresión de Cox Supervivencia |
| author |
Canale , MG Muñoz, FL Díaz , MP |
| author_facet |
Canale , MG Muñoz, FL Díaz , MP |
| author_sort |
Canale , MG |
| title |
Decreasing incidence of lung cancer and unfavorable survival prognosis: study of temporal trends in burden and survival by histology |
| title_short |
Decreasing incidence of lung cancer and unfavorable survival prognosis: study of temporal trends in burden and survival by histology |
| title_full |
Decreasing incidence of lung cancer and unfavorable survival prognosis: study of temporal trends in burden and survival by histology |
| title_fullStr |
Decreasing incidence of lung cancer and unfavorable survival prognosis: study of temporal trends in burden and survival by histology |
| title_full_unstemmed |
Decreasing incidence of lung cancer and unfavorable survival prognosis: study of temporal trends in burden and survival by histology |
| title_sort |
decreasing incidence of lung cancer and unfavorable survival prognosis: study of temporal trends in burden and survival by histology |
| description |
Lung cancer (LC) is the fourth most incident cancer in Argentina and the leading cause of cancer-related death. Survival rates are low. Sex, age, and histology play a significant role in the burden and temporal trends. We analyzed the incidence and survival of LC in Córdoba, Argentina, from 2004 to 2014, considering the effects of age, sex, and histology.
We conducted a longitudinal ecological study. Using data from the Provincial Cancer Registry, specific age-standardized LC incidence rates (ICD-10: C33-34) were calculated (per 100,000 person-years) by sex, year (2004-2014), and histological types (small cell carcinoma (SCLC), and non-small cell carcinoma (NSCLC): adenocarcinoma, squamous cell carcinoma, large cell carcinoma, and other carcinomas). Joinpoint regression models were used to analyze temporal trends, estimating annual percentage changes (APC). For survival, median survival times and estimated survival curves were calculated, and semiparametric Cox regression models were adjusted. Statistical significance was verified using logarithmic rank tests and proportional hazards tests. Software used: Joinpoint Regression Program® and Stata 17.
Between 2004 and 2014, 8,246 cases of LC were diagnosed in individuals aged 35-84. Cases were more frequent in males (72%), with the highest incidence among those aged 75-79 and 80-84, in females. The male age-standardized rate was 57.9, and the female rate was 23.6 cases per 100,000 person-years. In both sex, the temporal trend of incidence decreased (APC -3.21%, p=0.001), with a greater decline in males (APC -3.99%, p=0.011), exhibiting negative APCs in all histological subtypes, significant in squamous cell carcinoma (APC -5.8, p<0.001), and other carcinomas (APC -8.2, p=0.004). The probability of survival decreased to 32% (95% CI: 31%-34%) within just 12 months (38% for females, 30% for males). The risk of death increased proportionally with age (male HR: 1.007 (95% CI: 1.004-1.01, p=0.000); female HR: 1.005 (95% CI: 1.00-1.01, p=0.031)) and across all histological types, with relatively lower proportional risks in females and variations based on histology: for males, the highest risk was in large cell carcinoma (p=0.008) and SCLC, and for females (p=0.055).
Despite estimating a favorable trend in LC incidence since 2004, survival prognosis remains unfavorable within the first year of diagnosis, dependent on sex and histological type. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2023 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/42809 |
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I10-R327-article-428092023-10-19T21:19:05Z Decreasing incidence of lung cancer and unfavorable survival prognosis: study of temporal trends in burden and survival by histology Incidencia decreciente de cáncer pulmón y pronóstico desfavorable de sobrevida: estudio de tendencias temporales de carga y supervivencia según histología . Canale , MG Muñoz, FL Díaz , MP Joinpoint Regression Cox Regression Survival Regresión Joinpoint Regresión de Cox Supervivencia Lung cancer (LC) is the fourth most incident cancer in Argentina and the leading cause of cancer-related death. Survival rates are low. Sex, age, and histology play a significant role in the burden and temporal trends. We analyzed the incidence and survival of LC in Córdoba, Argentina, from 2004 to 2014, considering the effects of age, sex, and histology. We conducted a longitudinal ecological study. Using data from the Provincial Cancer Registry, specific age-standardized LC incidence rates (ICD-10: C33-34) were calculated (per 100,000 person-years) by sex, year (2004-2014), and histological types (small cell carcinoma (SCLC), and non-small cell carcinoma (NSCLC): adenocarcinoma, squamous cell carcinoma, large cell carcinoma, and other carcinomas). Joinpoint regression models were used to analyze temporal trends, estimating annual percentage changes (APC). For survival, median survival times and estimated survival curves were calculated, and semiparametric Cox regression models were adjusted. Statistical significance was verified using logarithmic rank tests and proportional hazards tests. Software used: Joinpoint Regression Program® and Stata 17. Between 2004 and 2014, 8,246 cases of LC were diagnosed in individuals aged 35-84. Cases were more frequent in males (72%), with the highest incidence among those aged 75-79 and 80-84, in females. The male age-standardized rate was 57.9, and the female rate was 23.6 cases per 100,000 person-years. In both sex, the temporal trend of incidence decreased (APC -3.21%, p=0.001), with a greater decline in males (APC -3.99%, p=0.011), exhibiting negative APCs in all histological subtypes, significant in squamous cell carcinoma (APC -5.8, p<0.001), and other carcinomas (APC -8.2, p=0.004). The probability of survival decreased to 32% (95% CI: 31%-34%) within just 12 months (38% for females, 30% for males). The risk of death increased proportionally with age (male HR: 1.007 (95% CI: 1.004-1.01, p=0.000); female HR: 1.005 (95% CI: 1.00-1.01, p=0.031)) and across all histological types, with relatively lower proportional risks in females and variations based on histology: for males, the highest risk was in large cell carcinoma (p=0.008) and SCLC, and for females (p=0.055). Despite estimating a favorable trend in LC incidence since 2004, survival prognosis remains unfavorable within the first year of diagnosis, dependent on sex and histological type. El cáncer de pulmón (CP) es el cuarto cáncer más incidente en Argentina y primera causa de muerte por cáncer. La sobrevida es baja. El sexo, edad e histología son relevantes en la carga y tendencia temporal. Analizamos la incidencia y sobrevida del CP en Córdoba-Argentina-, 2004-2014, considerando el efecto de edad, sexo e histología. Se condujo estudio ecológico longitudinal. A partir de datos del Registro Provincial de Tumores se calcularon tasas de incidencia de CP (CIE-10: C33-34) específicas por edad y estandarizadas (población estándar mundial) (TIE, por 100.000 personas-año) truncadas (35-84 años) por sexo, año (2004-2014) y tipos histológicos (carcinoma de células pequeñas (SMCC) y células no pequeñas (NSCLC): adenocarcinoma, células escamosas, células grandes y otros carcinomas). Para el análisis temporal se ajustaron modelos de regresión Joinpoint, estimando cambios porcentuales anuales (PCA). Para sobrevida se calcularon medianas de tiempo, curvas estimadas de supervivencia y ajustaron modelos semiparamétricos de regresión de Cox. La significación estadística se verificó mediante pruebas de rango logarítmico y de riesgos proporcionales. Softwares: Joinpoint-Regression-Program® y Stata 17. Durante 2004-2014 se diagnosticaron 8.246 CP en sujetos de 35-84 años. Los casos fueron más frecuentes en hombres (72%), incidencia máxima entre 75-79 años y 80-84, en mujeres. La TIE masculina fue 57,9 y la femenina 23,6 casos / 100.000 años-persona. En ambos sexos, la tendencia temporal de incidencia fue decreciente (PCA-3,21%; p=0,001) y mayor en hombres (PCA-3,99%, p=0,011) con PCAs negativos en todos los subtipos histológicos y significativo en células escamosas (PCA-5,8, p<0,001) y otros carcinomas (PCA-8,2, p=0,004). La posibilidad de sobrevida disminuyó al 32% (IC95%: 31%-34%) en solo 12 meses (38% mujeres, 30% hombres). El riesgo de muerte aumentó proporcionalmente con edad (hombres HR: 1,007 (IC95%:1,004-1,01, p=0,000); mujeres HR:1,005 (IC95%: 1,00-1,01, p=0,031) y en todos los tipos histológicos, con riesgos proporcionales menores en mujeres y disimilitudes según histología: en hombres el mayor riesgo fue en células grandes (p=0,008) y SMCC, en mujeres (p=0,055). A pesar de estimar una tendencia favorable de la incidencia CP desde el 2004, el pronóstico de sobrevida continúa siendo adverso al año del diagnóstico, dependiente del sexo y del tipo histológico. . Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023-10-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/42809 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 80 (2023): Suplemento JIC XXIV Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 80 (2023): Suplemento JIC XXIV Revista da Faculdade de Ciências Médicas de Córdoba; v. 80 (2023): Suplemento JIC XXIV 1853-0605 0014-6722 spa https://revistas.unc.edu.ar/index.php/med/article/view/42809/42831 Derechos de autor 2023 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |