Favorable trends in lung cancer incidence with unfavorable survival prognosis: A spatiotemporal analysis by histology in Córdoba, Argentina

Abstract

Lung cancer (LC) represents the leading cause of cancer-related death and the third in incidence in Argentina. Survival rates are low. Objective: To analyze the spatial distribution of LC incidence in Córdoba-Argentina (2004‐2014), explore trends in histological types, and estimate the probability of survival.

Methods

A longitudinal ecological study was conducted using data from the Provincial Cancer Registry. Age-specific and standardized incidence rates for LC (ICD-10: C33–34) were calculated, truncated (35–84 years), and stratified by sex, year (2004–2014), and histology (small cell carcinoma and non-small cell: adenocarcinoma, squamous cells, large cells, and other carcinomas). Temporal analysis employed Joinpoint regression models, estimating annual percentage changes (APC). Median times estimated survival curves and semiparametric Cox regression models were employed for survival. Statistical significance: log-rank tests and proportional hazards tests. Software: Joinpoint-Regression-Program and Stata17.

Results

From 2004–2014, 8246 LC cases were diagnosed in individuals aged 35–84. The highest incidence occurred in males aged 75–79 and females aged 80–84. The Age-standardized incidence rates for males and females were 57.9 and 23.6 cases per 100,000 person-years, respectively. In both sexes, the temporal incidence trend was decreasing (APC −3.21 %; p = 0.001), more pronounced in males (APC −3.99 %, p = 0.011), with negative APCs in all histological subtypes. The probability of survival decreased to 32 % (95 %CI: 31 %-34 %) within just 12 months (38 % in females, 30 % in males). The risk of death increased proportionally with age (males HR: 1.007, (95 %CI: 1.004–1.01, p = 0.000); females HR: 1.005, (95 %CI: 1.00–1.01, p = 0.031)) and across all histological types, with lower proportional risks in females and disparities based on histology: in males, the highest risk was in large cells (p = 0.008) and SMCC, while in females, it was SCLC (p = 0.055).

Conclusions

Despite estimating a favorable trend in LC incidence since 2004, the survival prognosis remains unfavorable one-year post-diagnosis, dependent on sex, age, and histological type.