Five statistically significant predictors of mammographic screening among Sri Lankan women were identified. These suggest that higher health awareness and exposure to health care providers are important predictors.

Introduction Lung cancer is the second commonest cancer among males in Sri Lanka. Real-world survival data are scarce, and we conducted a retrospective survival analysis among patients treated for lung cancer. Methods All patients with primary lung cancer treated at three selected units during 2015–2016 were included in the study. Data on clinicopathological and treatment delivered were extracted from clinic records. Overall survival was considered the primary end-point. Results The study population comprised 349 patients. The median age was 61 years and majority of patients (74%) were males. Adenocarcinoma (56%) was the commonest histological subtype, followed by squamous cell carcinoma (26%), whereas 6% of patients had small cell lung cancer. Only 10% of patients with non-small cell lung cancer were treated with curative intent, whereas 67% presented with systemic metastases. The median overall survival was 12 months in patients treated with curative intent and there was no significant difference between radical surgery and radiotherapy. The median overall survival was 3 months in those treated palliatively. On multivariate analysis, female gender and first-line treatment with tyrosine kinase inhibitors was associated with superior survival. Conclusion More than 90% of lung cancer patients in Sri Lanka are treated with palliative intent. Further work is needed to identify patient and care pathway barriers to ensure diagnosis at an earlier stage.

Background: Lung cancer is the leading cause of cancer-related mortality and most common cancer in worldwide with more than a million deaths annually. Despite vigorous improvement in diagnostics

Introduction Novel systemic therapeutic options such as enzyme inhibitors and monoclonal antibodies have transformed the practice of medical oncology in the recent past. However, survival gains remain modest in most cases. Quantifying the magnitude of benefit against financial and non-financial toxicity of treatment is pivotal in deciding treatment. We describe a novel metric which can be used to assess effectiveness novel therapeutics for incurable cancers. Methods The median overall survival was divided by the median duration of treatment to obtain the overall survival gain per treatment time which was the primary end-point of the study. This parameter was compared with the European Society of Medical Oncology Magnitude of clinical benefit scale (ESMO-MCBS) score. Spearman's rank correlation coefficient was used to test the association between the novel metric and the ESMO-MCBS scores. Results Data were available for 30 drugs across 60 indications. The median overall survival per unit treatment time ranged from 0.68 (range 0.2-0.51). Only 18/60 indications had a ratio greater than 1 while 13/60 indications had a ratio less than 0.5. The median treatment duration was not mentioned in 11 indications and median progression free survival was substituted for the analysis. The ESMO-MCBS score was available for 49 of the indications. The Spearman's rank correlation coefficient was 0.44575 and showed a statistically significant association between survival gain per unit treatment time and the ESMO-MCBS score (p = 0.00133). Conclusions Along with other metrics, the ratio of survival gain over treatment duration is a useful parameter to assess effectiveness of novel therapeutics in the palliative setting.