Department of Public Health, University of Otago, PO Box 7343, Wellington, New Zealand; Nuffield Department of Population Health, University of Oxford, Big Data Institute, Old Road Campus, Oxford, OX3 7LF, UK.
Inequalities in Cancer Outcomes Network, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Lung Cancer. 2021 Jul;157:92-99. doi: 10.1016/j.lungcan.2021.05.015. Epub 2021 May 13.
Age is an important prognostic factor for lung cancer. However, no studies have investigated the age difference in lung cancer survival per se. We, therefore, described the role of patient-related and clinical factors on the age pattern in lung cancer excess mortality hazard by stage at diagnosis in New Zealand.
We extracted 22 487 new lung cancer cases aged 50-99 (median age = 71, 47.1 % females) diagnosed between 1 January 2006 and 31 July 2017 from the New Zealand population-based cancer registry and followed up to December 2019. We modelled the effect of age at diagnosis, sex, ethnicity, deprivation, comorbidity, and emergency presentation on the excess mortality hazard by stage at diagnosis, and we derived corresponding lung cancer net survival.
The age difference in net survival was particularly marked for localised and regional lung cancers, with a sharp decline in survival from the age of 70. No identified factors influenced age disparities in patients with localised cancer. However, for other stages, females had a greater difference in survival between middle-age and older-age than males. Comorbidity and emergency presentation played a minor role. Ethnicity and deprivation did not influence age disparities in lung cancer survival.
Sex and stage at diagnosis were the most important factors of age disparities in lung cancer survival in New Zealand.
年龄是肺癌的一个重要预后因素。然而，尚无研究单独探讨肺癌生存的年龄差异。因此，我们描述了在新西兰，与患者相关的因素和临床因素在诊断时各分期肺癌超额死亡风险的年龄模式中的作用。
我们从新西兰基于人群的癌症登记处提取了 2006 年 1 月 1 日至 2017 年 7 月 31 日期间诊断的年龄为 50-99 岁（中位年龄为 71 岁，47.1%为女性）的 22487 例新肺癌病例，并随访至 2019 年 12 月。我们建立了模型，以研究诊断时的年龄、性别、种族、贫困、合并症和紧急就诊对各分期肺癌超额死亡风险的影响，并得出相应的肺癌净生存。
局部和区域性肺癌的净生存年龄差异尤其显著，70 岁以后生存率急剧下降。没有发现任何因素影响局部癌症患者的年龄差异。然而，对于其他分期，女性的中龄和高龄之间的生存差异大于男性。合并症和紧急就诊的作用较小。种族和贫困状况并不影响肺癌的生存年龄差异。
在新西兰，性别和诊断时的分期是肺癌生存年龄差异的最重要因素。
