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Lung Cancer News Today:

Advanced NSCLC Patients Live Longer When Treated, but Proportion of Untreated Patients Rising

Patients with advanced non-small cell lung cancer (NSCLC) who receive treatment live longer than those who don’t. But, the proportion of NSCLC patients with advanced disease who don’t receive treatment has been rising in the United States.

Lung cancer is the No. 1 cause of cancer-related deaths in the U.S. An estimated 158,080 people are expected to die from the disease in 2017. Only 17 percent of patients with advanced NSCLC (stages 3 and 4) live longer than five years after being diagnosed. This is true in spite of new treatments and an increase in clinical trial enrollment.

Treatment guidelines have been established for each stage of NSCLC. But, large proportion of patients do not receive treatment at all.

Who doesn’t get treatment?

“Overall, the proportion of untreated patients with NSCLC varies by stage, ranging from 7% to 45%, but in subsets of older, medically inoperable patients, the untreated population can reach as high as 90%,” Elizabeth A. David, MD, from the University of California Davis Medical Center, and colleagues wrote in the study.

“We hypothesized that patients who are older, poorly educated, without health insurance, and with a higher disease stage would have a higher likelihood of being untreated, but we also hypothesized that there are a substantial number of untreated patients who are statistically similar to patients who undergo treatment.”

Using data from the National Cancer Datadase from 1998 to 2012, researchers analyzed several parameters in patients with primary NSCLC, including gender, disease stage, type of treatment (radiation, chemotherapy, or surgery), annual income, education, and year of diagnosis.

The analysis showed that 21 percent of patients (190,539) had received no treatment. Also, the more advanced the disease stage, the higher the proportion of untreated patients.

In fact, during the study period, the proportion of untreated patients with stage 1 and 2 NSCLC decreased by 0.66% and 0.23%, respectively. But the proportion of untreated patients with stage 3A and 4 disease increased by 0.21% and 0.4%, respectively.

Across all disease stages, untreated patients were likely to be older and have Medicare instead of private insurance. Results showed that these older patients had shorter overall survival (OS), regardless of age. Treated patients at stage 3A lived a median of 16.5 months. Treated patients at stage 4 lived a median of 9.3 months. Untreated patients at stage 3A lived a median of 6.1 months after diagnosis. And, untreated patients at stage 4, lived a median of 2.0 months after diagnosis.

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