Survival in never-smokers with non-small cell lung cancer: A population-based study from Sweden

Löfling, Lukas; Bahmanyar, Shahram; Karimi, A.; Kieler, Helle; Lambe, Mats; Lundström, Kristina Lamberg; Sandin, Fredrik; Wagenius, Gunnar

doi:10.1093/annonc/mdy291.004

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“…The National Lung Cancer Register and Lung Cancer Database Sweden Data on NSCLC patients diagnosed in Sweden between 2002 and 2016 were retrieved from the Lung Cancer Database Sweden (LCBaSe). LCBaSe is a research database generated by record linkage between the National Lung Cancer Register (NLCR) and the Swedish Cancer Register (SCR), the Cause of Death Register (CDR), the National Patient Register (NPR), the Prescribed Drug Register (PDR), the Longitudinal Integration Database for Health, Insurance and Labour Market Studies (LISA) and the National Population Register [27].…”

Section: Methodsmentioning

confidence: 99%

Clinical characteristics and survival in non-small cell lung cancer patients by smoking history: a population-based cohort study

et al. 2019

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Introduction: Approximately, 10-15% of lung cancer patients have never smoked. Previous epidemiological studies on non-tobacco associated lung cancer have been hampered by selected data from a small number of hospitals or limited numbers of patients. By use of data from large population-based registers with national coverage, this study aims to compare characteristics and survival of patients with non-small cell lung cancer (NSCLC) with different smoking histories. Methods: Swedish national population-based registers were used to retrieve data on patients diagnosed with primary NSCLC between 2002 and 2016. The Kaplan-Meier method and Cox proportional hazard models were used to estimate overall survival and lung cancer-specific survival by smoking history. Results: In total, 41,262 patients with NSCLC were included. Of those, 4624 (11%) had never smoked. Never-smokers were more often women and older compared to ever smokers (current and former). Adenocarcinoma was proportionally more common in never-smokers (77%) compared to current (52%) and former smokers (57%). Stage IV disease was more common in neversmokers (57%) than in current (48%) and former smokers (48%). Epidermal growth factor receptor mutation was observed more in never-smokers (37%) compared to current (5%) and former smokers (9%). Both lung cancer-specific and overall survival were higher for never-smokers compared to current smokers. Conclusions: The observed differences in characteristics between never-smokers and smokers, and the higher survival in never-smokers compared to smokers from this large population-based study provide further evidence that lung cancer in never-smokers is clinically different to tobacco-associated lung cancer. The findings from this study emphasise the need for an improved understanding of genetics, pathogenesis, mechanisms and progression of non-tobacco associated lung cancer that may help prevent lung cancer or identify individually targeted treatments. ARTICLE HISTORY

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Section: Methodsmentioning

confidence: 99%