Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: Analysis of the surveillance, epidemiologic, and end results database
Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: Analysis of the surveillance, epidemiologic, and end results database
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DOI：
10.1200/jco.2005.04.4859
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发表时间：
2006-10-01
影响因子：
45.3
通讯作者：
Piccirillo, Jay
中科院分区：
文献类型：
--
作者：
Govindan, Ramaswamy;Page, Nathan;Piccirillo, Jay
目的小细胞肺癌（Small-cell lung cancer，SCLC）是肺癌的一种组织学亚型，具有独特的生物学和临床过程。据观察，小细胞肺癌的发病率一直在下降，在过去的几年里，MethodsWe使用的监测，流行病学和最终结果（SEER）数据库，以确定小细胞肺癌的发病率在过去的30年。此外，我们试图确定在过去30年（1973年至2002年）报告的肺癌病例中，小细胞肺癌的发病率和生存率的性别和分期差异。联合点分析，以测试的趋势，每年的百分比变化的统计significance.ResultsThe比例的小细胞肺癌（所有肺癌组织学类型）从1986年的17.26%下降到2002年的12.95%。在所有小细胞肺癌患者中，女性小细胞肺癌患者的比例从1973年的28%增加到2002年的50%。一个温和的，但统计学上显着改善2年和5年的生存率之间的有限阶段的小细胞肺癌和广泛阶段的小细胞肺癌cohort在研究period.ConclusionOur分析表明，小细胞肺癌的发病率正在下降，在美国，只有适度的改善已经看到在过去的30年中的生存。发病率下降的可能解释包括吸烟者比例下降和改用低焦油过滤嘴香烟。尽管生存率有适度改善的趋势，但结局仍然很差。
PurposeSmall-cell lung cancer (SCLC) is a histologic subtype of lung cancer with a distinct biology and clinical course. It has been observed that the incidence of SCLC has been decreasing over the last several years.MethodsWe used the Surveillance, Epidemiologic, and End Results (SEER) database to determine the incidence of SCLC over the last 30 years. In addition, we sought to determine sex- and stage-based differences in the incidence and survival of SCLC among a proportion of reported cases of lung cancer over the last 30 years (1973 to 2002). Joinpoint analyses were applied to test the trends in annual percentage change for statistical significance.ResultsThe proportion of SCLC (among all lung cancer histologic types) decreased from 17.26% in 1986 to 12.95% in 2002. Of all patients with SCLC, the proportion of women with SCLC increased from 28% in 1973% to 50% in 2002. A modest but statistically significant improvement in 2- and 5-year survival was noted among both limited-stage SCLC and extensive-stage SCLC cohorts during the study period.ConclusionOur analysis indicates that the incidence of SCLC is decreasing in the United States, and only modest improvements have been seen in survival over the last 30 years. Possible explanations for the decreasing incidence include the decrease in the percentage of smokers and the change to low-tar filter cigarettes. Despite trends toward modest improvement in survival, the outcome remains very poor.