Many lung cancer patients do not receive recommended care

  • Blom EF & al.
  • Ann Am Thorac Soc
  • 1 Nov 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Nearly 40% of US patients with lung cancer do not receive the treatment recommended by national guidelines.

Why this matters

  • The data highlight targets for improving receipt of guideline-recommended care, including in local and advanced NSCLC and extended-disease SCLC.

Study design

  • 441,812 patients with lung cancer from the National Cancer Database diagnosed between 2010 and 2014.
  • Funding: National Cancer Institute.

Key results

  • 62.1% received recommended treatment (from 50.4% in advanced NSCLC to 76.3% in local NSCLC).
  • 16.3% received less intensive treatment than recommended (from 6.4% in extensive disease SCLC to 21.6% in locally advanced NSCLC).
  • 21.6% received no treatment (from 10.3% in local NSCLC to 31.4% in advanced NSCLC).
  • Receipt of recommended treatment decreased with advancing age (age, ≥80 years vs 
  • Among patients with local NSCLC, older patients were less likely to undergo surgery (aOR, 0.06; 95% CI, 0.05-0.06) and more likely to receive stereotactic body radiation therapy (aOR, 18.39; 95% CI, 14.09-23.99).
  • Compared with whites, receipt of recommended treatment was less likely in non-Hispanic blacks (aOR, 0.78; 95% CI, 0.76-0.80) and Hispanics (aOR, 0.94; 95% CI, 0.90-0.98), and more likely among non-Hispanic Asians (aOR, 1.09; 95% CI, 1.04-1.15).

Limitations

  • Only first course of treatment considered.