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

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology Pub Date : 2025-03-13 DOI:10.1016/j.canep.2025.102796

Marcela Guadalupe Canale , Fabian Leonardo Muñoz , Sonia Edith Muñoz , Maria del Pilar Diaz

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引用次数: 0

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.

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肺癌发病率的有利趋势与不利的生存预后：阿根廷Córdoba的组织学时空分析

肺癌是导致癌症相关死亡的主要原因，在阿根廷的发病率中排名第三。存活率很低。目的：分析Córdoba-Argentina (2004 - 2014) LC发病率的空间分布，探讨其组织学类型的变化趋势，并估计其生存概率。方法利用省癌症登记处的资料进行纵向生态学研究。计算LC （ICD-10: C33-34）的年龄特异性和标准化发病率，截断（35-84岁），并按性别、年份（2004-2014）和组织学（小细胞癌和非小细胞癌：腺癌、鳞状细胞癌、大细胞癌和其他癌）分层。时间分析采用Joinpoint回归模型，估计年百分比变化（APC）。生存率采用中位数估计生存曲线和半参数Cox回归模型。统计显著性：对数秩检验和比例风险检验。软件：Joinpoint-Regression-Program和Stata17。结果2004-2014年，35-84岁人群中LC确诊病例8246例。发病率以75 ~ 79岁男性和80 ~ 84岁女性最高。男性和女性的年龄标准化发病率分别为57.9例和23.6例/ 10万人年。在两性中，时间发病率呈下降趋势(APC - 3.21 %；p = 0.001)，在男性中更为明显（APC - 3.99 %,p = 0.011），在所有组织学亚型中APC均为阴性。在短短12个月内，生存率降至32% %(95% %CI: 31 %-34 %)（女性38 %，男性30 %）。死亡风险随年龄成比例增加(男性HR: 1.007,(95 %CI: 1.004-1.01, p = 0.000)；女性HR: 1.005,(95 %CI: 1.00-1.01, p = 0.031))，在所有组织学类型中，女性的比例风险较低，基于组织学的差异：在男性中，风险最高的是大细胞（p = 0.008）和SMCC，而在女性中，风险最高的是SCLC （p = 0.055）。结论：尽管自2004年以来估计LC发病率呈有利趋势，但诊断后一年的生存预后仍然不利，这取决于性别、年龄和组织学类型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Epidemiology 医学-肿瘤学

CiteScore

4.50

自引率

3.80%

发文量

200

审稿时长

39 days

期刊介绍： Cancer Epidemiology is dedicated to increasing understanding about cancer causes, prevention and control. The scope of the journal embraces all aspects of cancer epidemiology including: • Descriptive epidemiology • Studies of risk factors for disease initiation, development and prognosis • Screening and early detection • Prevention and control • Methodological issues The journal publishes original research articles (full length and short reports), systematic reviews and meta-analyses, editorials, commentaries and letters to the editor commenting on previously published research.