Patterns of care of non-small cell lung cancer patients in China and implications for survival

Abstract

Purpose: We reported the patterns of care for a cohort of Chinese patients with nonsmall cell lung cancer (NSCLC) and examined the characteristics of those patients who did not receive cancer-specific treatment. Materials and Methods: This was a prospective cohort study. The study population was patients with first primary NSCLC diagnosed and admitted to Hebei Cancer Hospital in Hebei Province in China from January 2004 to December 2005. Logistic regression was used to examine factors associated with no cancer-specific treatment. Cox proportional hazard regression was used to examine the effects of cancer treatment on survival. Results: Of 579 NSCLC patients included in the study, 73.4% were male, 84.3% died by the end of the study after 7 years follow-up, 40.1% were diagnosed at a late stage of disease, and 33.7% had unknown disease stage. Over half (50.8%) of the patients received palliative care, 23.8% for curative care, and 25.4% did not receive any cancer-specific treatment. The probability of not receiving cancer-specific treatment was significantly higher for those who diagnosed at older age (odds ratio [OR] =3.01, 95% confidence interval [95% CI]: 1.79–5.06), had unknown stage at diagnosis (OR = 2.77, 95% CI: 1.41–5.47), or had unclassified histological type (OR = 3.48, 95% CI: 1.94-6.21). After adjusted for other factors, patients received anti-cancer treatment had significantly lower risk of dying from NSCLC P < 0.0001) compared with patients who did not receive any cancer-specific treatment. Conclusions: Despite the benefits of anti-cancer treatments confirmed in this study, over a quarter patients did not receive any such treatment. Finding the reasons for the patients who did not receive cancer-specific treatment may improve the quality of patient care in this population.