Undertreatment trend in elderly lung cancer patients in Brazil
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Elderly patients with lung cancer tend to be undertreated in comparison to younger patients. The objective of this study is to compare treatment modalities offered to lung cancer patients from 70 years of age or more with patients under 70.
For this study, an analytical cross-sectional epidemiological study conducted with data from the Brazilian hospital-based cancer registries between the years 2000 and 2011. In addition, odds ratios (OR) were calculated, with a 95% confidence intervals (95% CI), in conjunction with the construction of a logistic regression model.
By analyzing the records of 40,403 patients with lung cancer, we found that overall, patients from 70 years of age or more corresponded to 28.6% of the study population. Squamous cell carcinoma was the most common histological type among patients ≥70 years of age, whereas adenocarcinoma was the more prevalent type among younger patients. In comparison to younger patients, the older ones were treated less often (OR = 0.57; 95% CI: 0.52–0.62). Moreover, older patients were less likely to undergo surgery (OR = 0.69; 95% CI: 0.64–0.75), radiotherapy (OR = 0.86; 95% CI: 0.81–0.92), chemotherapy (OR = 0.61; 95% CI: 0.57–0.64), or an association of two or more treatment modalities (OR = 0.58; 95% CI: 0.54–0.62).
The study finds that Brazilian lung cancer patients ≥70 years of age are often undertreated and higher percentage of early death rates as compared to patients under 70. In regard to treatment, age alone should not determine whether patients with lung cancer are treated or not.
KeywordsLung cancer Elderly patients Undertreatment Brazil
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest regarding the present study.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The internal review board of the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) approved the study protocol under reference number 3681 in 2013.
For this type of study, informed consent is not required.
The authors have no funding to report.
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