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H. Monsanto
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MINI 11 - Tobacco Control and Prevention (ID 108)
- Event: WCLC 2015
- Type: Mini Oral
- Track: Prevention and Tobacco Control
- Presentations: 1
- Moderators:S.M. Janes, E. Stone, K.M. Cummings
- Coordinates: 9/07/2015, 16:45 - 18:15, 601+603
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MINI11.09 - Trends in Lung Cancer Mortality Attributable to Smoking, Years of Potential Life Lost and Financial Cost, Puerto Rico 1983-2010 (ID 1719)
16:45 - 18:15 | Author(s): H. Monsanto
- Abstract
- Presentation
Background:
During 1983, 2000 and 2004 the lung cancer deaths attributable to smoking (LCDAS) were 64.1% (>15 years old), 76% (> 35 years old) and 71% (34-65 years old), respectively. Objectives: a) LCDAS; b) Years of Potential Life Lost (YPLL) due LCDAS; c) cost associated with YPLL for the LCDAS.
Methods:
Mortality data of lung cancer (ICD-10, C33-C34) from the National Center for Health Statistics for Puerto Rico (2010) was analyzed. The prevalence of current, former and never smoking by gender was obtained from the Behavioral Risk Factor Surveillance System (2010) (CDC, US) and the Relative Risk of death dues to smoking by gender from the Cancer Prevention Study-II. The Smoke Attributable Fraction (SAF) was calculated as [p~0 ~+ p~cs ~* RR~cs ~+ p~fs ~* RR~fs ~] – 1 / [p~0 ~+ p~cs ~* RR~cs ~+ p~fs ~* RR~fs ~], where p~0 ~= prevalence of never smoker, p~cs ~= prevalence current smoker, p~fs~ = prevalence of former smoker, RR~cs, ~= Relative Risk of current smoker and RR~fs~ = Relative Risk of former smoker. The LCDAS (D~as~) were calculated as D~o~*SAF, where D~o~ = deaths observed of lung cancer 2010. To compare the data of 1983, 2000 and 2010, SAF was calculated by sex for the total population (not by age groups), with correspondent same death-risk LCDAS. YPLL used life expectancy (women=82.56 years old; men=74.85 years old). The method of willingness to pay, using three times the GDP per capita in 2010 (US$82,353), a discount rate of 3% and an annual increase of 1%, to calculate the economic cost.
Results:
In 2010, 50.3% deaths by lung cancer in women were LCDAS, men 83.7% , in 1983 women and men were 65.9% and 91.2% respectively and in 2000, 58.9% and 84.4% women and men respectively; percentage of all LCDAS (2010) was 73.3% (by sex and group of five). Total population, 2010, not by age groups 75.8%, 2000, 76.3% and1983, 82.5%. In 2010, SAF higher in women was in the age group=45-49 (smoker=13%, SAF=0.66); men was in the age group of 50-54 years (SAF=0.86) (smoker= 17.5%). In women, 1% point decreased (1983-2010) in the prevalence of smoking representing 1.5% point of decreasing LCDAS; men 1% point representing 0.3% point. Lung cancer YPLL in >35 years old represented in 2010 a total of 4,597 years [3,239 years (70.5%) were LCDAS], men accounted 2,383 years [2,014 (84.5%) years LCDAS] and women accounted 2,214 years [1,225 (55.4%) years LCDAS]. In 2010 the cost (willingness to pay) associated for men was $166 million [$139 million (84%) LCDAS], and for women was S146 million [$82 million (56%) LCDAS]. The Average Years Life Lost LCDAS for men was 10.6 years and for women 14.2 years.
Conclusion:
LCDAS have been decreasing in Puerto Rico, as demonstrated in the reduction of SAF. LCDAS occur at an earlier age in women than in men. Notwithstanding , the financial cost of LCDAS is greater in men than in women. Total financial cost for LCDAS represented 0.3% of the Puerto Rico GDP in 2010.
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P3.05 - Poster Session/ Prevention and Tobacco Control (ID 217)
- Event: WCLC 2015
- Type: Poster
- Track: Prevention and Tobacco Control
- Presentations: 2
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.05-007 - Lung Cancer and Multiple Causes of Death, Puerto Rico, 2010 (ID 1710)
09:30 - 17:00 | Author(s): H. Monsanto
- Abstract
Background:
In 2010, 615 people died from lung cancer in Puerto Rico, representing 11.8% of all deaths from cancer and 2.1% of all causes of death. Objectives: The objectives were to: a) determine the underlying cause of death; b) determine the prevalence of conditions reported; c) determine the place of death; and d) determine the marital status as a proxy of network support; all the previous objectives were analyzed by gender.
Methods:
The Mortality Multiple Cause-of-Death Public Use Record from the National Center for Health Statistics for Puerto Rico (2010) was analyzed. The variables analyzed were: sex, age, place of death (Hospital, Clinic or Medical Center – Inpatient; Hospital, Clinic or Medical Center - Outpatient or admitted to Emergency Room; Hospital, Clinic or Medical Center - Dead on Arrival; Decedent’s home; Hospice facility; Nursing home/long term care; Other; Place of death unknown), marital status (divorced, married, never married, widowed, marital status unknown), underlying cause, number of condition and condition. Relative and absolute frequencies were calculated; and for the gender comparisons, T-test, Chi square and OR were used.
Results:
The underlying most frequent cause of death (610 deaths, 99.2%) was the malignant neoplasm of unspecified part of bronchus or lung (ICD-10 code C34.9), four deaths (0.6%) were attributed to primary metastatic malignant neoplasm involving the trachea (ICD-10 code C33) and another death (0.2%) was from malignant neoplasm of upper lobe, bronchus or lung. More than 68% of deaths presented 3 or less conditions (including the underlying condition). The most prevalent conditions were: diseases of the circulatory system (67.3%; women (68%) and men (67%)), diseases of respiratory system (48.4%; women (46.3%) and men (49.5%)), other malignant neoplasm (13.9%; women (17.4%) and men (12.1%)), diabetes (11.7%; women (12.9%) and men (11.1%)), and zoonotic and bacterial infections (10.2%). More men (67.3%; n=414) than women (32.7%; n=201) died from lung cancer. A great majority of the deaths were in individuals 65 years and older (86.4%; n= 530). The most frequent places of death were in the decedent’s home (47%; n=289) and as an inpatient in a Hospital, Clinic or Medical Center (44.2%; n=272). No significant differences were found between place of death and gender. Regarding the marital status, 47% (n=289) were married (women (36.8%) men (52%); p< 0.05), 15.6% (n=96) were divorced, 14.3% (n=88) had never married, and 23% (n=141) were widowed (women (36.3%) men (16.4%); p<0.05).
Conclusion:
The majority patient who die from lung cancer have important comorbidities that need to be addressed during the disease, die at home or as inpatients, and are not married. Given these findings, a strong support network may be important for the patient who has lung cancer.
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P3.05-008 - Lung Cancer, Burden of Disease, Puerto Rico 2000-2010 (ID 1715)
09:30 - 17:00 | Author(s): H. Monsanto
- Abstract
Background:
The Annual Percent Change (APC) of lung cancer mortality has decreased from 1987 until 2010 by 1.5% for men and 1.1% for women, representing 13.8% and 9.7% of all cancer deaths among men and women for the period 2006-2010, respectively (Puerto Rico Cancer Registry, last issue from 2011). Objectives: The objectives were to: a) estimate both Years of Potential Life Lost (YPLL) and Potentially Productive Years of Life Lost (PPYLL) for lung cancer in Puerto Rico (2000-2010) by gender; b) estimate the Average Years of Life Lost (AYLL) by gender; c) estimate the cost associated with YPLL by gender.
Methods:
Mortality data from the National Center for Health Statistics for Puerto Rico (2000 and 2010) was analyzed. An upper limit of 80 years was established for the YPLL, in accordance with WHO guidelines. The YPLL was divided by the total deaths in each year to calculate the Average Years of Life Lost (AYLL). The PPYLL was calculated by setting an interval from 16 to 65 years (Puerto Rico Labor Department). The method of willingness to pay, using three times the GDP per capita in 2010 (US$82,353)(Puerto Rico Planning Board), with a discount rate of 3% and an annual increase of 1%, was used to calculate the economic cost.
Results:
In 2010, the YPLL for lung cancer represented a total of 6,311 years, 11.2% of YPLL for all cancer types, while in 2010 it represented a total of 5,893 years, 10.6 % of YPLL for all cancer types. The YPLL for men in 2000 accounted for 4,301 years (71.5% of YPLL for lung cancer) whereas in 2010 it accounted for 3,843 years (65.2% of YPLL for lung cancer). For women in 2000, the YPLL accounted for 2,010 years (28.5% of YPLL for lung cancer) while in 2010 it accounted for 2,050 years (34.8% of YPLL for lung cancer). The YPLL for both genders decreased 6.6% in the period 2000-2010. The AYLL for men in 2000 and 2010 was 13.5 years and 12.4 years, respectively, and for women 14.4 years and 15.2 years, respectively. The PPYLL in 2000 was 1,085 years for men and 479 years for women, whereas in in 2010 it was 776 years for men and 589 years for women. The economic cost (willingness to pay) associated to YPLL for men was $287.6 million and $261.5 million for 2000 and 2010, respectively, and for women it was $134.5 million and $134.4 million for 2000 and 2010, respectively.
Conclusion:
The YPLL has remained stable for women and decreased for men from 2000 to 2010 and the PPYLL has decreased for men when compared to women. Lung cancer deaths occur in younger women than men. The financial burden associated with women has remained constant while for men it has decreased. These findings suggest that lung cancer continues to be a public health problem with substantial burden of disease among men and women in Puerto Rico.
