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    P1.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 947)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 2
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.15-10 - Comparison of Selected Colombian National Administrative Cancer Registry (NACR) Data in Lung Cancer with the U.S. (ID 12487)

      16:45 - 18:00  |  Presenting Author(s): Robert Hsu

      • Abstract
      • Slides

      Background

      Lung cancer (LC) is the seventh leading cause of cancer in Colombia and the leading cause of cancer mortality in the United States. In Colombia, previous estimates of lung cancer have been limited to city specific cancer registry (Cali Cancer Registry) and broad estimates from GLOBOCAN. The Colombian Health Ministry in 2015 created the National Administrative Cancer Registry (NACR) to obtain national cancer data. We investigated selected 2016 NACR data and compared it to data from the U.S. to gauge for areas of improvement in lung cancer delivery.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We obtained NACR data compiled from the Colombian Department of Health Ministry regarding lung cancer from 2015-2016. We compared this to U.S. data consisting of Surveillance, Epidemiology, and End Results (SEER) and National Cancer Database (NCDB) data from 2003-2015.

      4c3880bb027f159e801041b1021e88e8 Result

      NACR data in 2016 shows incidence of 1.7 cases per 100,000 and mortality of 2.5 cases per 100,000. SEER data from 2015 shows incidence of 47.2 cases per 100,000 and mortality of 40.6 cases per 100,000. NACR data shows average age of 66 (IQR = 65.7-66) while NCDB data shows median age to be in the age 60-69 category. NACR data in 2016 shows that 14.02% of 849 diagnosed LC patients received surgery compared to 24.83% of 168,093 diagnosed non-small cell lung cancer and small cell lung cancer patients in 2015 from the NCDB. NACR data demonstrates that of those receiving chemotherapy with documented regimens (n=275), 52% received carboplatin, 28.3% received pemetrexed, 27.6% received cisplatin, 25.4% received paclitaxel, 10.9% received bevacizumab, and 5.1% received erlotinib. In comparison, SEER data from 2000-2011 show metastatic NSCLC patients receiving antineoplastic agents (n = 2022) with increasing use of pemetrexed (39.2%), erlotinib (20.3%), and bevacizumab (18.9%) and declining use of paclitaxel (38.7%), gemcitabine (17.0%), and vinorelbine (5.7%). NACR data shows median wait time from diagnosis to first treatment of 31 days (IQR=14-62, n=346) compared to NCDB data showing median wait time of 35 days from diagnosis to first treatment.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Data shows significantly higher incidence and mortality in the U.S.; this is multifactorial due to screening and data reporting. Comparison shows higher rates of surgery and use of biologics in the U.S. There were similar wait times from diagnosis to first treatment and age of LC patients. Limitations include limited reporting on chemotherapy, radiation, and staging. Future improvements from a Colombian standpoint will include outcomes data collection, increased screening, resources for surgery, and updated access to antineoplastic agents.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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      P1.15-26 - A Review of Colombian National Administrative Cancer Registry (NACR) Data to Evaluate Healthcare Delivery and Biologics Use (ID 14354)

      16:45 - 18:00  |  Author(s): Robert Hsu

      • Abstract
      • Slides

      Background

      The Office of High Cost of the Colombian Health Ministry created the National Administrative Cancer Registry (NACR) data first in 2015 to provide comprehensive cancer data to improve cancer outcomes while serving as a model for other resource-limited countries. Despite new targeted therapies throughout the world, the benefits of these therapies have not reciprocated in lower resource settings, notably in Latin America. The purpose of this study is to investigate aspects of the NACR data that underscore some of the health care limitations of lung cancer treatment in Colombia.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We obtained National Administrative Cancer Registry (NACR) data from the High-Cost Diseases Office (Cuenta de Alto Costo [CAC]) collected in 2015 and released in 2016. All cancer cases diagnosed in the country are reported by payers and providers otherwise there are no payments for services rendered, assuring that the registry is representative. We use descriptive statistics for presentation of data and comparisons.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 3,082 patients were analyzed of which 2,043 (66.29%) had contributive insurance, 820 (26.60%) had subsidized insurance, and 98 (3.18%) had special or exempt insurance. Four patients (0.12%) had no insurance. Of newly diagnosed patients, the median number of days from suspicion to diagnosis was 27 days (IQR = 12-45 days, n = 491) with the predominant range of patients with contributive insurance being 30-59 days, and for subsidized insurance being 15-29 days. The median number of days from diagnosis to first treatment was 31 days (IQR=14-62, n=346) with the predominant range for patients with both contributive and subsidized insurance being 30-59 days. There was a greater percentage of Stage IV cancers in patients with subsidized (34%) than contributive (23%) insurance. Of those receiving chemotherapy (n=275), 52% received carboplatin, 28.3% received pemetrexed, 27.6% received cisplatin, 25.4% received paclitaxel, 10.9% received bevacizumab, and 5.1% received erlotinib; no patients received nivolumab or pembrolizumab.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Based on findings from NACR, the wait time from suspicion to treatment took nearly two months underscoring the need for better streamline of lung cancer care. Also, data shows a low percentage of use of newer therapies, including EGFR-targeted agents despite a high prevalence of mutations, which are present in around a quarter of patients in Colombia (Raez, 2017). Colombia can strongly benefit from increased access to molecular testing and biologics given the future direction of lung cancer therapy.

      6f8b794f3246b0c1e1780bb4d4d5dc53

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.