Cancer Res Treat.  2019 Jul;51(3):1241-1248. 10.4143/crt.2018.513.

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

• Choi WI
• Choi J
• Kim MA
• Lee G
• Jeong J
• Lee CW

• KMID: 2454315
• DOI: http://doi.org/10.4143/crt.2018.513

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.

Keyword

Lung neoplasms; Age; Treatment

MeSH Terms

Diagnosis
Drug Therapy
Humans
Logistic Models
Lung Neoplasms*
Lung*
Medicaid
Myocardial Infarction
National Health Programs
Primary Health Care
Referral and Consultation
Renal Insufficiency, Chronic

Figure

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  Fig. 1. Flow chart of the study. ICD-10, International Classification of Diseases, 10th revision.

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  Fig. 2. Kaplan-Meier curves for 5-year survival in all lung cancer patients. Patients who received treatment (any type of chemotherapy, radiotherapy, or surgery) (red line) and patients who did not (blue line) were compared.

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  Fig. 3. Kaplan-Meier curves for 5-year survival in lung cancer patients > 80 years old. Patients who received treatment (any type of chemotherapy, radiotherapy, or surgery) (red line) and patients who did not (blue line) were compared.

Reference

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