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Wei TMD, Ning WMD, Yao HMD, Yujie WMD, Lin NMD. Correlation between Clinicopathological Features and Spectral CT Imaging of Lung Squamous Cell Carcinoma. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2020. [DOI: 10.37015/audt.2020.190027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Krebs P, Rogers E, Greenspan A, Goldfeld K, Lei L, Ostroff JS, Garrett BE, Momin B, Henley SJ. Utility of Using Cancer Registry Data to Identify Patients for Tobacco Treatment Trials. JOURNAL OF REGISTRY MANAGEMENT 2019; 46:30-36. [PMID: 32010425 PMCID: PMC6993933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Many tobacco dependent cancer survivors continue to smoke after diagnosis and treatment. This study investigated the extent to which hospital-based cancer registries could be used to identify smokers in order to offer them assistance in quitting. The concordance of tobacco use coded in the registry was compared with tobacco use as coded in the accompanying Electronic Health Records (EHRs). METHODS We gathered data from three hospital-based cancer registries in New York City during June 2014 to December 2016. For each patient identified as a current combustible tobacco user in the cancer registries, we abstracted tobacco use data from their EHR to independently code and corroborate smoking status. We calculated the proportion of current smokers, former smokers, and never smokers as indicated in the EHR for the hospitals, cancer site, cancer stage, and sex. We used a logistic regression model to estimate the log odds of the registry-based smoking status correctly predicting the EHR-based smoking status. RESULTS Agreement in current smoking status between the registry-based smoking status and the EHR-based smoking status was 65%, 71%, and 90% at the three participating hospitals. Logistic regression results indicated that agreement in smoking status between the registry and the EHRs varied by hospital, cancer type, and stage, but not by age and sex. CONCLUSIONS The utility of using tobacco use data in cancer registries for population-based tobacco treatment interventions is dependent on multiple factors including accurate entry into EHR systems, updated data, and consistent smoking status definitions and registry coding protocols. Our study found that accuracy varied across the three hospitals and may not be able to inform interventions at these hospitals at this time. Several changes may be needed to improve the coding of tobacco use status in EHRs and registries.
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Affiliation(s)
| | | | | | | | - Lei Lei
- NYU School of Medicine, New York, NY
| | | | - Bridgette E Garrett
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Behnoosh Momin
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - S Jane Henley
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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El Zoghbi M, Salameh P, Stücker I, Paris C, Pairon JC, Gislard A, Siemiatycki J, Bonneterre V, Clin B, Brochard P, Delva F, Lacourt A. Phenotypes of lung cancer and statistical interactions between tobacco smoking and occupational exposure to asbestos and crystalline silica from a large case-only study: The CaProMat study. Lung Cancer 2017; 112:140-155. [DOI: 10.1016/j.lungcan.2017.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 07/28/2017] [Accepted: 08/06/2017] [Indexed: 12/23/2022]
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Sullivan DR, Ganzini L, Duckart JP, Lopez-Chavez A, Deffebach ME, Thielke SM, Slatore CG. Treatment receipt and outcomes among lung cancer patients with depression. Clin Oncol (R Coll Radiol) 2013; 26:25-31. [PMID: 24080122 DOI: 10.1016/j.clon.2013.09.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 08/05/2013] [Accepted: 08/06/2013] [Indexed: 01/10/2023]
Abstract
AIMS Among lung cancer patients, depression has been associated with increased mortality, although the mechanisms are unknown. We evaluated the association of depression with mortality and receipt of cancer therapies among depressed veterans with lung cancer. MATERIALS AND METHODS A retrospective, cohort study of lung cancer patients in the Veterans Affairs-Northwest Health Network from 1995 to 2010. Depression was defined by ICD-9 coding within 24 months before lung cancer diagnosis. Multivariable Cox proportional analysis and logistic regression were used. RESULTS In total, 3869 lung cancer patients were evaluated; 14% had a diagnosis of depression. A diagnosis of depression was associated with increased mortality among all stage lung cancer patients (hazard ratio = 1.14, 95% confidence interval: 1.03-1.27, P = 0.01). Among early-stage (I and II) non-small cell lung cancer (NSCLC) patients, the hazard ratio was 1.37 (95% confidence interval: 1.12-1.68, P = 0.003). There was no association of depression diagnosis with surgery (odds ratio = 0.83, 95% confidence interval: 0.56-1.22, P = 0.34) among early-stage NSCLC patients. A depression diagnosis was not associated with mortality (hazard ratio = 1.02, 95% confidence interval: 0.89-1.16, P = 0.78) or chemotherapy (odds ratio = 1.07, 95% confidence interval: 0.83-1.39, P = 0.59) or radiation (odds ratio = 1.04, 95% confidence interval: 0.81-1.34, P = 0.75) receipt among advanced-stage (III and IV) NSCLC patients. Increased utilisation of health services for depression was associated with increased mortality among depressed patients. CONCLUSIONS Depression is associated with increased mortality in lung cancer patients and this association is higher among those with increased measures of depression care utilisation. Differences in lung cancer treatment receipt are probably not responsible for the observed mortality differences between depressed and non-depressed patients. Clinicians should recognise the significant effect of depression on lung cancer survival.
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Affiliation(s)
- D R Sullivan
- Health Services Research & Development, Portland Veterans Affairs Medical Center, Portland, OR, USA; Division of Pulmonary & Critical Care Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
| | - L Ganzini
- Health Services Research & Development, Portland Veterans Affairs Medical Center, Portland, OR, USA
| | - J P Duckart
- Health Services Research & Development, Portland Veterans Affairs Medical Center, Portland, OR, USA
| | - A Lopez-Chavez
- Division of Hematology and Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - M E Deffebach
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR, USA; Section of Pulmonary & Critical Care Medicine, Portland Veterans Affairs Medical Center, Portland, OR, USA
| | - S M Thielke
- Departments of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA; Geriatric Research, Education, and Clinical Center, Puget Sound Veterans Affairs Medical Center, Seattle, Washington, USA
| | - C G Slatore
- Health Services Research & Development, Portland Veterans Affairs Medical Center, Portland, OR, USA; Division of Pulmonary & Critical Care Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR, USA; Section of Pulmonary & Critical Care Medicine, Portland Veterans Affairs Medical Center, Portland, OR, USA
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Remon J, Lianes P, Martínez S, Velasco M, Querol R, Zanui M. Adjuvant treatment in resected non-small cell lung cancer: current and future issues. Crit Rev Oncol Hematol 2013; 88:375-86. [PMID: 23809199 DOI: 10.1016/j.critrevonc.2013.05.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 05/17/2013] [Accepted: 05/31/2013] [Indexed: 12/25/2022] Open
Abstract
The cornerstone of treatment for early-stage non-small cell lung cancer (NSCLC) has been surgical resection. In the last five years two phase III trials have provided evidence of adjuvant platinum-based chemotherapy for completely resected stage II-IIIA patients. We review the evidence supporting adjuvant therapy in early-stage NSCLC; we discuss new issues surrounding adjuvant therapy such as treatment in the elderly-unfit population, treatment toxicity and its influence on outcomes, the importance of histology and gender in adjuvant treatment; and we discuss the future landscape of early-stage NSCLC research, namely, therapeutic strategies exploiting pharmacogenomic and gene-expression profiling, in an attempt to customize the treatment.
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Affiliation(s)
- Jordi Remon
- Medical Oncology Department, Hospital de Mataró, Carretera de la Cirera, s/n, 08304 Mataró, Barcelona, Spain.
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Difference in survival and prognostic factors between smokers and never-smokers with advanced non-small-cell lung cancer. Int J Clin Oncol 2011; 18:17-25. [PMID: 22072116 DOI: 10.1007/s10147-011-0334-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Accepted: 09/24/2011] [Indexed: 12/30/2022]
Abstract
BACKGROUND Our aims were to investigate whether the association between smoking and survival is significant when adjusted for prognostic factors including use of epidermal growth factor tyrosine kinase inhibitors and the Glasgow Prognostic Score, an established score for inflammation, and to explore prognostic factors. METHODS We analyzed 244 patients with stage IIIB or IV non-small-cell lung cancer in a registry, including only chemotherapy-receiving outpatients with performance status zero. RESULTS Of 244 patients, 170 had died and the median follow-up time for the 74 surviving patients was 12.0 months. In multivariate Cox regression, smoker (hazard ratio compared to never-smoker: 1.67, P < 0.01), stage IV (hazard ratio compared to IIIB: 1.72, P < 0.01), and elevated C-reactive protein level (hazard ratio per 1 mg/dL increase: 1.08, P < 0.01) were significantly associated with shorter survival. The association between survival and smoking was significant, even after adjustment for the Glasgow Prognostic Score and regimens of chemotherapy (hazard ratio: 1.72, P = 0.02). In never-smokers, increased neutrophils were a major determinant of shorter survival and the interaction test between smoking and neutrophils was significant (hazard ratio per 1,000/mm(3) increase for smokers: 1.01; hazard ratio per 1,000/mm(3) increase for never-smokers: 1.44, P for interaction <0.01). CONCLUSIONS Known factors including treatment response or inflammatory process are not responsible for the fact that advanced non-small-cell lung cancer patients without any history of smoking have better survival than those who have smoked.
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Slatore CG, Au DH, Gould MK. An official American Thoracic Society systematic review: insurance status and disparities in lung cancer practices and outcomes. Am J Respir Crit Care Med 2010; 182:1195-205. [PMID: 21041563 DOI: 10.1164/rccm.2009-038st] [Citation(s) in RCA: 130] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Insurance coverage is an important determinant of access to care and is one potential cause of disparities in lung cancer care outcomes. OBJECTIVES We performed a systematic review of the available literature to examine the association between insurance status and lung cancer practices and outcomes. METHODS We searched multiple electronic databases through November 6, 2008 for studies that examined the association between lung cancer outcomes and insurance status. Two reviewers independently selected studies. One investigator evaluated their quality according to predetermined criteria, and abstracted data about study design, patients' demographic and clinical characteristics, and outcome measures. MEASUREMENTS AND MAIN RESULTS Of 3,798 potentially relevant studies, 23 met eligibility criteria and were included. Studies reported heterogeneous outcomes among heterogeneous samples of patients that precluded a quantitative synthesis. In general, compared with patients with private or Medicare insurance, patients with Medicaid or no insurance had poorer lung cancer outcomes, including higher incidence rates, later stage at diagnosis, and poorer survival. Overall, patients with Medicaid or no insurance were less likely to undergo curative procedures, but patients without insurance were more likely to receive guideline-concordant care. CONCLUSIONS Patients with Medicaid or no insurance consistently had worse outcomes than other patients with lung cancer. Some of the disparities may be secondary to residual confounding from smoking and other health behaviors, but available data suggest that patients with lung cancer without insurance do poorly because access to care is limited and/or they present with more advanced disease that is less amenable to treatment.
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Abstract
OBJECTIVE In 2009, a new TNM staging system was published by the International Union Against Cancer and the American Joint Committee on Cancer. The new edition will encompass non-small cell lung cancer, small cell lung cancer, and bronchopulmonary carcinoids. This article will review many important changes that have been made in the revised staging system. CONCLUSION It is important that radiologists learn the new system and understand the reasons for the changes to provide more accurate clinical staging.
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Cost-effectiveness of a smoking cessation program implemented at the time of surgery for lung cancer. J Thorac Oncol 2009; 4:499-504. [PMID: 19204575 DOI: 10.1097/jto.0b013e318195e23a] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Many patients are active smokers at the time of a diagnosis of surgically resectable lung cancer. Perioperative smoking cessation is associated with improved survival, but the cost-effectiveness of a smoking cessation program initiated immediately before surgery is unknown. METHODS We developed a decision analytic Markov model to evaluate the incremental cost-effectiveness of a formal smoking cessation program. The parameter estimates were taken from the available literature. The model included the cost and effectiveness of the smoking cessation program, cost and incidence of perioperative complications, postoperative mortality, and utility measured in quality adjusted life years (QALY). Dollars per QALY and life year were calculated and one-way sensitivity analyses were performed. RESULTS The cost/QALY and cost/life year were $16,415 and $45,629 at 1 year after surgery and $2609 and $2703 at 5 years, respectively. Most sensitivity analyses showed the 1 year postsurgery cost/QALY estimates were less than $50,000, and all were less than $12,000 at 5 years. Cost-effectiveness estimates were most sensitive to the frequency of perioperative complications and the estimated short-term utility estimates. CONCLUSION A smoking cessation program initiated before surgical lung resection is cost-effective at both 1 and 5 years postsurgery. Providers should encourage patients who are still smoking to engage in formal smoking cessation programs.
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Zhang L, Lee JJ, Tang H, Fan YH, Xiao L, Ren H, Kurie J, Morice RC, Hong WK, Mao L. Impact of smoking cessation on global gene expression in the bronchial epithelium of chronic smokers. Cancer Prev Res (Phila) 2008; 1:112-8. [PMID: 19138944 DOI: 10.1158/1940-6207.capr-07-0017] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cigarette smoke is the major cause of lung cancer and can interact in complex ways with drugs for lung cancer prevention or therapy. Molecular genetic research promises to elucidate the biological mechanisms underlying divergent drug effects in smokers versus nonsmokers and to help in developing new approaches for controlling lung cancer. The present study compared global gene expression profiles (determined via Affymetrix microarray measurements in bronchial epithelial cells) between chronic smokers, former smokers, and never smokers. Smoking effects on global gene expression were determined from a combined analysis of three independent data sets. Differential expression between current and never smokers occurred in 591 of 13,902 measured genes (P < 0.01 and >2-fold change; pooled data)--a profound effect. In contrast, differential expression between current and former smokers occurred in only 145 of the measured genes (P < 0.01 and >2-fold change; pooled data). Nine of these 145 genes showed consistent and significant changes in each of the three data sets (P < 0.01 and >2-fold change), with eight being down-regulated in former smokers. Seven of the eight down-regulated genes, including CYP1B1 and three AKR genes, influence the metabolism of carcinogens and/or therapeutic/chemopreventive agents. Our data comparing former and current smokers allowed us to pinpoint the genes involved in smoking-drug interactions in lung cancer prevention and therapy. These findings have important implications for developing new targeted and dosing approaches for prevention and therapy in the lung and other sites, highlighting the importance of monitoring smoking status in patients receiving oncologic drug interventions.
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Affiliation(s)
- Li Zhang
- Department of Bioinformatics. The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA.
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