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Phuong T Ngo



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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: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.15-23 - Factors Affecting Treatment in Non-Small Cell Lung Cancer Patients (ID 14054)

      16:45 - 18:00  |  Presenting Author(s): Phuong T Ngo

      • Abstract
      • Slides

      Background

      Lung cancer continues to be the leading cause of cancer deaths with Kentucky having the highest incidence of lung cancer. Despite advances in treatment and subsequent survival improvements, a significant number of non-small cell lung cancer (NSCLC) patients remain untreated. Factors such as age, stage at diagnosis and insurance status appear to play an important role in this disparity.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      In the Kentucky LEADS Collaborative, 27 of 31 (81%) Kentucky hospital registries provided all NSCLC data from 2012-2015. Variables collected included hospital accreditation by the Commission on Cancer (CoC), patient age at diagnosis, stage, race, number of comorbidities, insurance status, and overall survival (OS). Treatment included combinations of surgery, radiation, chemotherapy or immunotherapy. Hospital records were matched to the Kentucky Cancer (KCR) records and analyzed with a logistic regression model along with additional post-hoc analysis.

      4c3880bb027f159e801041b1021e88e8 Result

      Of the 13,975 patients diagnosed with NSCLC, 10,367 (74.2%) were treated leaving 3,608 (25.8%) untreated. Overall survival reported as person-days was significantly longer for the treated versus untreated patients (593 days vs 161 days). Neither race nor gender showed statistical significance while age at the time of diagnosis was significant with the untreated patients being diagnosed at a mean age of 72 and the treated patients at a mean age of 66 (p=<0.001). The mean average of comorbidities reported was 4.1 for treated patients and 4.4 for untreated patients though the specific comorbidities were not discernable. Treatment versus lack of treatment was also significantly associated with stage at the time of diagnosis with 87.9% vs 12.1% for stage I, 88.2% vs 11.8% for stage II, 73.9% vs 26.1% for stage III, and 64.2% vs 35.8% in stage IV; untreated patients tended to present at a later stage than those who received treatment with OR 2.91 (95% CI 2.57-3.28) for stage III and OR 4.28 (95% CI 4.29-5.41) for stage IV. Lastly, insurance proved to be an important factor with untreated patients more likely to have Medicaid, Medicare or be uninsured.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Treatment for lung cancer is correlated with improved outcomes and yet a large number of patients are still untreated. We aimed to assess these barriers to treatment and found untreated patients were more likely to be older, diagnosed at a later stage, and not have private insurance. While therapies are constantly changing and improving, it is important to factor in the many barriers that still exist in preventing patients from being treated.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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