Highlights
- •The percentage of patients diagnosed with stage I lung cancer is increasing.
- •This trend is observed in non−small-cell lung cancer but not in small-cell lung cancer.
- •The staging shift may be due to lung cancer screening and a higher detection of incidental lung nodules.
- •There are significant imbalances in the percentages of stage I lung cancer according to demographic characteristics.
Abstract
Introduction
The American Cancer Society has recently reported an increase in the percentage of
patients with localized lung cancer from 2004 to 2018, coinciding with the initial
lung cancer screening guidelines issued in 2013. We conducted a National Cancer Database
(NCDB) study to further evaluate the trends in stage I according to patient and tumor
characteristics.
Methods
We selected patients with lung cancer from the NCDB Public Benchmark Report diagnosed
between 2010 and 2017. Patients with stages I to IV according to the AJCC seventh edition
were evaluated according to the year of diagnosis, histology, age, sex, race, and
insurance.
Results
Among the 1,447,470 patients identified in the database, 56,382 (3.9%) were excluded
due to stage 0 or unknown, or incorrect histology, leaving 1,391,088 patients eligible.
The percentage of patients with stage I increased from 23.5% in 2010 to 29.1% in 2017
for all lung cancers, from 25.9% to 31.8% in non−small-cell lung cancer (NSCLC), and
from 5.0% to 5.4% in small-cell lung cancer (SCLC). Patients younger than 70 years,
males and blacks had lower percentages of stage I compared to older patients, females,
and nonblacks respectively. Patients with no insurance had the lowest percentage of
stage I.
Conclusions
There has been a significant increase in the percentage of stage I lung cancer at
diagnosis from 2010 to 2017, which occurred mostly in NSCLC. Although the staging
shift was observed in all subsets of patients, there were noticeable imbalances according
to demographic factors.
Keywords
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Article info
Publication history
Published online: November 20, 2022
Accepted:
November 10,
2022
Received in revised form:
November 2,
2022
Received:
August 26,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
