Abstract B29: Trends in racial disparities in five-year net survival for lung cancer, United States, 2001-2009
Authors: Richards Thomas B. , Henley S Jane , Puckett Mary C. , Weir Hannah K. , Huang Bin , Tucker Thomas C. 
Published: March 2017

Background: Net survival adjusts for age and other causes of death (background mortality).The CONCORD-2 study reported net survival data on cancer patients in 67 countries, including the United States. The purpose of this analysis is to describe lung cancer net survival by race and stage among 37 participating states covering approximately 80% of the US population.

Methods: We focused on adults (15-99 years) diagnosed 2001-09 with an invasive, primary cancer of the lung and bronchus (International Classification of Disease Oncology 3rd edition topography codes: C34.0-C34.3; C34.8-C34.9) and followed up to 31 December 2009. We categorized stage at diagnosis using Surveillance Epidemiology and End Results (SEER) Summary Stage (SS) 2000. We analyzed two calendar periods (2001-03 and 2004-09) because of changes in the way summary stage data was collected during these time periods in the United States. We estimated the percent five-year net survival with 95% confidence intervals (CI) using the cohort approach for patients diagnosed in 2001-03 and the complete approach for patients diagnosed during 2004-09. We utilized bar-charts and funnel plots to graphically present trends, geographic variations, and differences in survival by race between 2001-03 and 2004-09.

Results: Our study included 1,404,724 invasive, primary lung cancers. US five-year net survival for all races increased from 16.4% (95% CI: 16.3%-16.5%) in 2001-03 to 19.0% (95% CI: 18.8%-19.1%) in 2004-09. Between the two calendar periods, most states also showed a small increase in five-year net survival for lung cancer. The increase was more than 2.6% (the US increase) in most states in the Northeast, but less than 2.6% in many states in the South, Midwest, and West. During 2004-09, blacks had lower percent five-year net survival than whites for the following stage categories: all stages [blacks (14.9%; 95% CI: 14.5%-15.2%) versus whites (19.4%; 95% CI: 19.2%-19.5%)]; localized [blacks (45.9%; 95% CI: 44.4%-47.4%) versus whites (55.8%; 95% CI: 55.3%-56.2%)]; regional [blacks (22.0%; 95% CI: 21.0%-23.0%) versus whites (26.7%; 95% CI: 26.4%-27.0%); and unknown [blacks (11.0%; 95% CI: 10.0%-12.1%) versus whites (14.0%; 95% CI: 13.5%-14.5%)]. Blacks and whites had similar percent five-year net survival for distant stage [blacks (4.4%; 95% CI: 4.1%-4.7%) versus whites (4.7%; 95% CI: 4.6%-4.8%).

Conclusions: Lung cancer net survival is lower in blacks than in whites. Although the US overall and many states showed a small increase in the percent net survival from 2001-03 to 2004-09, the five-year net survival for lung cancer 2004-09 is much lower than for other common cancers. Only 46% of black patients and 56% of white patients diagnosed with local stage lung cancer survive five years.

Citation Format: Thomas B. Richards, S Jane Henley, Mary C. Puckett, Hannah K. Weir, Bin Huang, Thomas C. Tucker. Trends in racial disparities in five-year net survival for lung cancer, United States, 2001-2009. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B29.