Lung cancer survival in the United States by race and stage (2001‐2009): Findings from the CONCORD‐2 study

Abstract

BACKGROUND Results from the second CONCORD study (CONCORD-2) indicated that 5-year net survival for lung cancer was low (range, 10%–20%) between 1995 and 2009 in most countries, including the United States, which was at the higher end of this range. METHODS Data from CONCORD-2 were used to analyze net survival among patients with lung cancer (aged 15–99 years) who were diagnosed in 37 states covering 80% of the US population. Survival was corrected for background mortality using state-specific and race-specific life tables and age-standardized using International Cancer Survival Standard weights. Net survival was estimated for patients diagnosed between 2001 and 2003 and between 2004 and 2009 at 1, 3, and 5 years after diagnosis by race (all races, black, and white); Surveillance, Epidemiology, and End Results Summary Stage 2000; and US state. RESULTS Five-year net survival increased from 16.4% (95% confidence interval, 16.3%–16.5%) for patients diagnosed 2001–2003 to 19.0% (18.8%–19.1%) for those diagnosed 2004–2009, with increases in most states and among both blacks and whites. Between 2004 and 2009, 5-year survival was lower among blacks (14.9%) than among whites (19.4%) and ranged by state from 14.5% to 25.2%. CONCLUSIONS Lung cancer survival improved slightly between the periods 2001–2003 and 2004–2009 but was still low, with variation between states, and persistently lower survival among blacks than whites. Efforts to control well established risk factors would be expected to have the greatest impact on reducing the burden of lung cancer, and efforts to ensure that all patients receive timely and appropriate treatment should reduce the differences in survival by race and state.

Trends in the risk and burden of second primary malignancy among survivors of smoking‐related cancers in the United States

“…It could also be related to improved survival or treatment efficacy of the primary malignancy, thus allowing a longer survival and time for a second primary to develop. For example, the CONCORD‐2 study reported that lung cancer survival improved slightly between 2001 and 2003 and 2004–2009 . On the other hand, the burden of SPM among patients with urinary bladder and kidney and renal pelvis decreased from 2000 to 2014.…”

Population‐based cancer survival in the United States: Data, quality control, and statistical methods

“…If an age‐specific estimate could not be obtained, we merged data for adjacent age groups and assigned the combined estimate to both age groups. If 2 or more age‐specific estimates could not be obtained, we present only the pooled, unstandardized estimates for all ages combined: these estimates are italicized in Supporting Tables 2 and 3 in other articles of this supplement …”

“…If 2 or more agespecific estimates could not be obtained, we present only the pooled, unstandardized estimates for all ages combined: these estimates are italicized in Supporting Tables 2 and 3 in other articles of this supplement. [20][21][22][23][24][25][26][27][28][29] For each of the 37 states, we present estimates of age-standardized net survival for each cancer up to 5 years after diagnosis. For convenience, we report cumulative survival probabilities (range, 0-1) as percentages in the range of 0% to 100%.…”

Population‐based cancer survival (2001 to 2009) in the United States: Findings from the CONCORD‐2 study

“…The overall high percentage of microscopically verified cancers observed for all cancers, and the relatively low percentage of patients with solid tumors for whom stage at diagnosis was unknown, suggests that detailed clinical investigation at the time of diagnosis was performed for the majority of patients with cancer diagnosed during this time period. However, the large and consistent racial disparities described herein are likely due to the fact that cancers diagnosed in black men and women tended both to be diagnosed at a later stage and to have lower survival at each stage of diagnosis . These disparities often appeared within the first year after diagnosis, suggesting that additional factors, such as comorbidities and socioeconomic factors related to limited access to screening, diagnosis, treatment, and follow‐up care, may be relevant.…”