Author of

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  P2.01 - Advanced NSCLC (Not CME Accredited Session) (ID 950)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 26799

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    P2.01-05 - Adenocarcinoma of the Lung: The Woman’s Cancer? (ID 14356)

    16:45 - 18:00  |  Author(s): Michelle L Dean
    • Abstract
    • Slides

    Background
    

    We previously observed a significant interaction between sex and age-standardized incidence rates of Non-small cell lung cancer (NSCLC) patients showing higher rates of Adenocarcinoma (ADC) in women, from the systematic review of published studies within the last 20 years. Our analysis showed disparities across gender over time, and the main effect of gender on incidence rates is significant (p= 0.01). This study aimed to replicate observed sex-related disparities in published records using a 15-year retrospective analysis of a local large-scale database of NSCLC patients diagnosed in Southern Alberta, Canada.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    We extracted data from the Glans-Look Lung Cancer Database, a comprehensive clinical and demographic database of all lung cancer patients diagnosed in southern Alberta from 1999-2015. We assessed the impacts of gender on NSCLC risks and mortality. Clinical data e.g. smoking history, histology and NSCLC stage were collected and analyzed using chi-square test, and smoking history and tumor stage were stratified for the analysis. The Kaplan-Meier analysis was conducted to compare gender-based post diagnosis survival and disease progression. Statistical significance was 95% confidence level (p < 0.05).

    4c3880bb027f159e801041b1021e88e8 Result
    

    Among 7738 lung cancer patients, 95.6% (3743/7738) were NSCLC: 52% male and 48% female. Significant gender-based differences were observed in histology (p=0.00). SCC and ADC were the most frequent histology in both genders. However, ADC was commoner in women (49% vs 41%), while SCC was commoner in men (27% vs 17%). Relative changes of ADC rate over 15 years have increased significantly among women compared to men (58% vs 32%, P<0.02). The risk of developing NSCLC was greatly elevated with cigarette consumption in both genders; however, ADC in never smokers was higher in women (18%) compared to men (8%). Among ADC, smoking history and gender both showed a significant effect on survival, where mOS for never-smokers females exceeded that of never-smokers males [20 months vs 14 months, 95%CI, P=0.00]. The same trend was also seen in smokers [13 months vs 7 months, 95%CI, P=0.021]. In addition, the OS among male ADC cases was significantly lower than women of all tumor stages (P=0.00), but these disparities were insignificant across genders with SCC (P=0.46).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Similar to what we observed in our systematic review, gender influences the clinical course of NSCLC regardless of smoking history or stage in Southern Alberta. Identifying the cause of the increase in ADC rate over 15 years in women and higher prevalence of NSCLC in never smoking women warrants aggressive research strategies.

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