Original article: general thoracicGender differences in non–small-cell lung cancer survival: an analysis of 4,618 patients diagnosed between 1997 and 2002
Section snippets
Study population
Between January 1, 1997 and December 31, 2002, a cohort of 4,618 patients with pathologically diagnosed and/or confirmed NSCLC at Mayo Clinic (Minnesota, USA) were prospectively enrolled in this study and actively followed. Ninety-five percent of all new lung cancer patients seen at the Mayo Clinic were identified daily from our computerized pathology reporting system with the remaining 5% referred directly from the patient-care physicians. Only patients giving informed consent for research
Results
Among the 4,618 patients diagnosed with NSCLC during this six-year period, there were 2,724 men (59%) and 1,894 women (41%), a 1.44:1 male to female ratio. Median age at diagnosis was 68 years in men (range, 18 to 95) and 66 in women (range, 24 to 97), p less than 0.01. White was the most frequent ethnic group (95.6% of women and 96.8% of men). Minority groups included Alaskan/Indian, African American, Hispanic, Asian/Pacific Islanders, and Other.
Adenocarcinoma was the most frequent
Comment
This study confirms that male gender is an unfavorable prognostic factor for NSCLC survival. Our results show an increased mortality compared to women patients in our cohort of prospectively and actively followed series of patients diagnosed over a six-year period when histologic classification [18], staging system 18, 19 and treatment options for NSCLC remained constant. The survival for men in stage IA is similar to women in stage IB, men in stage IIA is similar to women in stage IIB, and so
Conclusion
Characteristics of our patient population reflect the current trends of lung cancer brought by changes in smoking behavior. Female patients smoke less but seem more susceptible to develop lung cancer earlier in life than male patients. Although adenocarcinoma is the most common subtype in both genders, women have proportionally more adenocarcinomas than men do. Women have a better survival than their male counterparts after considering age, smoking history, tumor histology and grade, stage,
Acknowledgements
We thank Drs Claude Deschamps, Daniel L. Miller, David E. Midthun, Alex A. Adjei, Aminah Jatoi, and Mark S. Allen for their input at various stages of this work. We also thank Susan Ernst for her technical assistance with the manuscript. This work was supported by grants CA 80127 and CA84354 from the US National Cancer Institute and by Mayo Foundation Funds.
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