Department of Medicine, Washington University School of Medicine, St. Louis, MO.
Department of Medicine, Division of Medical Oncology, Washington University School of Medicine, St. Louis, MO.
Clin Lung Cancer. 2023 Mar;24(2):114-119. doi: 10.1016/j.cllc.2022.11.005. Epub 2022 Nov 21.
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.
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.
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.
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.
美国癌症协会最近报告称，2004 年至 2018 年局部肺癌患者的比例有所增加，这与 2013 年首次发布的肺癌筛查指南相符。我们进行了国家癌症数据库（NCDB）研究，以根据患者和肿瘤特征进一步评估 I 期的趋势。
我们从 NCDB 公共基准报告中选择了 2010 年至 2017 年间诊断出的肺癌患者。根据 AJCC 第七版，根据诊断年份、组织学、年龄、性别、种族和保险，对 I 期至 IV 期的患者进行评估。
在数据库中确定的 1,447,470 名患者中，有 56,382 名（3.9%）因阶段 0 或未知或不正确的组织学而被排除在外，留下 1,391,088 名符合条件的患者。所有肺癌患者中，I 期患者的比例从 2010 年的 23.5%增加到 2017 年的 29.1%，非小细胞肺癌（NSCLC）从 25.9%增加到 31.8%，小细胞肺癌（SCLC）从 5.0%增加到 5.4%。年龄小于 70 岁、男性和黑人患者的 I 期比例低于年龄较大、女性和非黑人患者。没有保险的患者 I 期比例最低。
从 2010 年到 2017 年，肺癌的 I 期诊断比例显著增加，主要发生在 NSCLC 中。尽管在所有患者亚组中都观察到分期转移，但根据人口统计学因素存在明显的不平衡。
