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密歇根州 1996 年至 2017 年间确诊的肺癌和支气管癌患者总体生存率的流行病学研究。

Epidemiological study of overall survivability of individuals diagnosed with lung and bronchus cancer in Michigan between the years 1996 and 2017.

机构信息

University of Michigan Health Sparrow Hospital-Michigan State University, Lansing, Michigan, USA.

出版信息

Thorac Cancer. 2024 Oct;15(29):2110-2115. doi: 10.1111/1759-7714.15432. Epub 2024 Sep 4.

Abstract

INTRODUCTION

Lung and bronchus cancer is a leading cause of death in the United States. Compared with the national average, Michigan has an increased mortality rate and low early screening and treatment rates. This study aimed to explore the epidemiological trends and assess overall survival (OS) of patients diagnosed with lung cancer in Michigan from 1996 to 2017.

METHODS

Data was acquired from the Michigan Cancer Surveillance Program (MCSP). Log-rank test was used to test OS among the time periods, univariate and multivariate cox regression models were employed to determine factors that significantly affected OS. We hypothesized that the introduction of more inclusive lung cancer screening guidelines in 2013 would improve OS for patients diagnosed after its implementation and that individual characteristics and tumor characteristics would both affect OS.

RESULTS

Notably, 153 742 individuals met inclusion criteria: 54.22% male and 45.78% female. Mean age at diagnosis was 69 years. No significant difference in OS was found among the three time periods (p = 0.99). Univariate analyses identified four individual characteristics associated with reduced OS: age at diagnosis, male sex, American Indian race, and living in rural or urban area. Reduced OS was associated with primary sites tumors at main bronchus, lung base, or within overlapping lobes, and SEER stage 7.

CONCLUSIONS

This study highlights several factors that influence OS. Consideration of these factors may be helpful as a community outreach tool to help increase early detection and reduce overall mortality.

摘要

简介

肺癌和支气管癌是美国主要的致死病因。与全国平均水平相比,密歇根州的死亡率更高,早期筛查和治疗率较低。本研究旨在探讨密歇根州肺癌患者的流行病学趋势,并评估其 1996 年至 2017 年的总体生存率(OS)。

方法

数据来自密歇根癌症监测计划(MCSP)。采用对数秩检验比较各时间段的 OS,采用单变量和多变量 Cox 回归模型确定显著影响 OS 的因素。我们假设,2013 年更具包容性的肺癌筛查指南的引入将改善其实施后诊断患者的 OS,且个体特征和肿瘤特征均会影响 OS。

结果

共有 153742 名符合纳入标准的个体:54.22%为男性,45.78%为女性。诊断时的平均年龄为 69 岁。三个时间段的 OS 无显著差异(p=0.99)。单变量分析确定了四个与 OS 降低相关的个体特征:诊断时的年龄、男性、美洲印第安人种族以及居住在农村或城市地区。OS 降低与主支气管、肺基底或重叠叶内的原发部位肿瘤以及 SEER 分期 7 相关。

结论

本研究强调了影响 OS 的几个因素。考虑这些因素可能有助于作为社区外联工具,以帮助提高早期检测率并降低总体死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41da/11471430/7c6bb7865692/TCA-15-2110-g002.jpg

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