HIGHLIGHTS
- •Kentucky has significantly higher proportions of small cell and squamous cell carcinomas
- •Appalachian females have 3.5-fold higher incidence rates of small cell lung cancer than SEER
- •Appalachian males have 3.1-fold higher incidence rates of squamous cell carcinoma than SEER
- •Kentucky has more late-stage diagnoses and worse lung cancer survival than SEER
Abstract
Introduction
Kentucky is recognized as the state with the highest lung cancer burden for more than
2 decades, but how lung cancer differs in Kentucky relative to other US populations
is not fully understood.
Patients and Methods
We examined lung cancer reported to the Surveillance, Epidemiology, and End Results
(SEER) Program by Kentucky and the other SEER regions for patients diagnosed between
2012 and 2016. Our analyses included histologic types, incidence rates, stage at diagnosis,
and survival in Kentucky and Appalachian Kentucky relative to other SEER regions.
Results
We found that both squamous cell carcinomas and small-cell lung cancers represent
larger proportions of lung cancer diagnoses in Kentucky and Appalachian Kentucky than
they do in the SEER registries. Furthermore, age-adjusted cancer incidence rates were
higher in Kentucky for every subtype of lung cancer examined. Most notably, for Appalachian
women the rate of small-cell carcinomas was 3.5-fold higher, and for Appalachian men
the rate of squamous cell carcinoma was 3.1-fold higher, than the SEER rates. In Kentucky,
lung cancers were diagnosed at later stages and lung cancer survival was lower for
adenocarcinoma and neuroendocrine carcinomas than in SEER registries. Squamous cell
carcinomas and small-cell carcinomas were most lethal in Appalachian Kentucky.
Conclusion
Together, these data highlight the considerable disparities among lung cancer cases
in the United States and demonstrate the continuing high burden and poor survival
of lung cancer in Kentucky and Appalachian Kentucky. Strategies to identify and rectify
causes of these disparities are discussed.
Keywords
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Article info
Publication history
Published online: March 26, 2021
Accepted:
March 18,
2021
Received in revised form:
March 14,
2021
Received:
October 20,
2020
Identification
Copyright
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