Higher Age Puts Lung Cancer Patients at Risk for Not Receiving Anti-cancer Treatment

Abstract

Purpose We aimed to determine the demographic and epidemiologic variables that are associated with no treatment in lung cancer patients. Materials and Methods Patient data were collected from the Korean National Health Insurance Database. The lung cancer group included patients with an initial diagnosis of lung cancer between January 2009 and December 2014. Treated cases were defined as those that underwent surgery, radiation, or chemotherapy until death, after the diagnosis of lung cancer. Risk of no treatment was calculated by multiple logistic regression analysis. Results Among the 2,148 new cases of lung cancer from 2009 to 2104, 612 (28.4%) were not treated. Risk of no treatment was higher in the following patients: patients in their 60s (odds ratio [OR], 1.18; 95% confidence interval [CI], 0.75 to 1.84), 70s (OR, 3.64; 95% CI, 2.41 to 5.50), and >80 years old (OR, 16.55; 95% CI, 10.53 to 25.03) than those in their 50s; patients with previous myocardial infarction (OR, 2.07; 95% CI, 1.01 to 4.25) or chronic kidney disease (OR, 2.88; 95% CI, 1.57 to 5.30); and patients diagnosed at a non-referral hospital (OR, 1.40; 95% CI, 1.01 to 1.92) or primary care provider (OR, 1.81; 95% CI, 1.43 to 2.29) compared with referral hospital. Low-income patients receiving Medicaid were 1.75 times (95% CI, 1.14 to 2.68) more likely to forgo treatment than high-income patients (upper 20%). Risk was not associated with sex or the year in which the lung cancer was diagnosed. Conclusion Age predominantly determines whether patients with lung cancer undergo anti-cancer treatment.

Development and Validation of a Prognostic Nomogram in Lung Cancer With Obstructive Sleep Apnea Syndrome

“…The univariate and multivariate logistic analysis indicated that age, AHI, TNM stage, cancer types, BMI and ODI4 were risk factors for overall survival. Studies confirmed that age is an important factor in the occurrence of lung cancer and as an independent risk factor for survival and prognosis of lung cancer patients (19). The continuous increase of obstructive sleep apnea with age challenges the current theory that mortality due to obstructive sleep apnea and cardiovascular co-morbidities affect obstructive sleep apnea prevalence at an advanced age (20).…”

Prognostic outcome of treatment modalities for epidermal growth factor receptor-mutated advanced lung cancer

“…This database was described earlier [ 13 ]. Briefly, this study used data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) 2002 to 2015, released by the NHIS in 2015, which includes all medical claims filed from January 2002 to December 2015 for 1,031,392 nationally representative randomly selected patients, accounting for approximately 2.2% of the entire population of the NHIS in 2002.…”