Author of

• 11001

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  P1.24 - Poster Session 1 - Clinical Care (ID 146)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11053

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    P1.24-052 - Symptoms and early diagnosis of lung cancer. (ID 3443)

    09:30 - 16:30  |  Author(s): M.C. Nicolson
    • Abstract

    Background
    In the UK, the 5-year survival for lung cancer patients is less than 10%. One of the reasons contributing to this poor survival is the late stage at diagnosis, with approximately 80% of patients presenting with unresectable disease. CT screening of high risk patients may be effective but is expensive and still under investigation in clinical trials. Symptom-driven investigations may be more likely to detect advanced than early disease. We present data of the presenting symptom type and duration in patients diagnosed at an early, potentially curable stage.

    Methods
    Data from available casenotes of patients with resected non-small cell lung cancer were extracted by one data manager (NP) to study the main presenting symptom, other tumour-related symptoms, duration (where documented), smoking history and stage of disease. All patients were treated in a single institution between 2003 and 2008.

    Results
    105 patients’ details are included. 54 were male; age range 40-83 years, mean 67 years. Chest X-ray was abnormal in 103/105 patients. Smoking status was recorded in 83 (79%) cases. Three were never smokers. At time of diagnosis, 32 patients were still smoking and 17 had just quit. Of those who had stopped previously, 7 did so < 5 years before diagnosis, 5 at >5 < 10 years and 19 > 10 years before diagnosis. Pack year estimates were available in 91 patients and ranged from 5 to 180 (mean 40). Tumour stage at resection was 1a in 28, 1b in 29, IIa in 19, IIb in 15 and IIIa in 14. 25 patients had no symptoms (25%). The most common major presenting symptoms are in Table 1. Pre-diagnosis duration of symptoms was recorded in 67 patients (84%). 31 (39%) had >1 symptom.

    Dominant symptom	No of patients	Duration in months (mean)
    Cough	25	1-24 (3)
    +haemoptysis	10	0.5-6 (1)
    Lower respiratory infections	10	0.5-36 (3)
    Dyspnoea	10	0.25-12 (1)
    Chest/arm pain	9	2 hours – 4months (1)
    Weight loss	4	3-6
    Other	12	1-12 (2)
    None	25	-

    Conclusion
    CXR was abnormal in the majority of these patients with early tumours. The mean time to presentation with a dominant symptom was short. Almost a quarter of patients were asymptomatic and picked up as an icidental finding.The challenge to identify lung cancer patients early, at a curable stage, continues.

• 11929

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  P2.22 - Poster Session 2 - Epidemiology, Etiology (ID 167)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Prevention & Epidemiology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11941

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    P2.22-012 - Worse survival outcomes in patients with lung cancer from deprived areas of residence in Scotland: Why? (ID 3103)

    09:30 - 16:30  |  Author(s): M.C. Nicolson
    • Abstract

    Background
    Lung cancer survival remains poor with only modest progress in absolute terms in recent years. Survival has been lower in the UK than many comparable European countries. There is some evidence that this survival deficit is particularly apparent early during follow-up. Within the UK, survival has been lower among deprived patients. Recent evidence suggests that this 'derivation gap' in survival also predominates early during follow-up. Although early deaths could reflect advanced disease, previous research in both Scotland and England does not support the hypothesis that deprived patients with lung cancer present with more advanced disease.

    Methods
    Using Scottish lung cancer audit records linked to cancer registrations, hospital discharge records and mortality records, the aims of this project were 1) to describe patterns of survival from lung cancer by socio-economic position 2) to explore the influence of the 'deprivation gap' in survival factors such as age, sex, tumour stage, tumour morphology, emergency presentation, performance staus and co-morbidity by modelling deprivation category-specific relative survival.

    Results
    Preliminary results confirm that survival remains lower in patients with lung cancer from deprived areas of residence. In multivariate modelling, this finding does not seem to be explained by competing causes of death or stage of disease at diagnosis. The main explanatory variables seem to be performance status and treatment.

    Conclusion
    Preliminary analysis suggests that performance status and treatment are the most important explanations for the 'deprivation gap' in survival from lung cancer in Scotland.