Epidemiological and pathological distribution characteristics in 23 228 lung cancer patients_West China Medical Journal

Authors：

WANG Chengdi ¹ , CHEN Bojiang ¹ , SONG Lujia ² , SHAO Jun ¹ , LIU Dan ¹ ,  LI Weimin ¹

1. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LI Weimin, Email: weimi003@scu.edu.cn

Keywords：

Lung cancer; Epidemiology; Pathological type

DOI：

10.7507/1002-0179.202007093

Video：

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Objective To understand variations in clinical epidemiology of lung cancer and to help with early accurate diagnosis and treatment of lung cancer.Methods This research was based on the Lung Cancer Database of West China Hospital of Sichuan University. Clinicopathological data of inpatients with primary lung cancer from 2011 to 2018 was collected for analysis. Information regarding sex, age, smoking history, surgical resection modalities, TNM stage of tumor, and pathological subtypes was included.Results A total of 23 228 inpatients with primary lung cancer were included in this research. There were 1 932, 2 029, 2 162, 2 773, 2 975, 3 318, 3 993, and 4 046 patients in every single year from 2011 to 2018, respectively. The male-to-female ratio of patients had changed significantly from 2.00∶1 in 2011 to 1.34∶1 in 2018 (P<0.001). Statistically significant difference was found in age distribution of patients in different years, while elderly always accounted for the majority of all patients. More nonsmokers were among the group of lung cancer patients, the proportion of whom rose from 41.61% in 2011 to 52.47% in 2018 (P<0.001). The proportion of adenocarcinoma in all subtypes rose from 54.04% in 2011 to 71.73% in 2018, while the proportion of squamous carcinoma dropped from 29.04% to 17.67% simultaneously. From 2011 to 2018, the proportion of stage Ⅰ lung cancer rose from 15.68% to 40.79%. Patients with stage ⅠA1 accounted for 11.82% in 2018. In 2018, 60.78% of stage ⅠA patients had gone through surgical resection modalities, forming a stark contrast with the fact that only 26.48% of stage ⅠA patients adopted surgeries in 2011.Conclusions From 2011 to 2018, the total number of lung cancer patients increased year by year. The proportions of female patients and nonsmokers rose significantly. Adenocarcinoma accounted for the highest proportion of all subtypes, followed by squamous cell carcinoma. There were more patients with early lung cancer and less with advanced lung cancer diagnosed, implying a gradual accumulation of weight on the early stages according to the TNM classification of lung cancer.

Citation： WANG Chengdi, CHEN Bojiang, SONG Lujia, SHAO Jun, LIU Dan, LI Weimin. Epidemiological and pathological distribution characteristics in 23 228 lung cancer patients. West China Medical Journal, 2020, 35(7): 813-820. doi: 10.7507/1002-0179.202007093 Copy

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14.	Siegel RL, Jacobs EJ, Newton CC, et al. Deaths due to cigarette smoking for 12 smoking-related cancers in the United States. JAMA Intern Med, 2015, 175(9): 1574-1576.
15.	Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review 1975-2016, updated December 11, 2019. [2020-07-01]. https://seer.cancer.gov/statistics/reports.html.
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18.	Rami-Porta R, Bolejack V, Crowley J, et al. The IASLC lung cancer staging project: proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol, 2015, 10(7): 990-1003.
19.	de Koning HJ, van der Aalst CM, de Jong PA, et al. Reduced lung-cancer mortality with volume CT screening in a randomized trial. N Engl J Med, 2020, 382(6): 503-513.
20.	Wang C, Wu Y, Shao J, et al. Clinicopathological variables influencing overall survival, recurrence and post-recurrence survival in resected stage I non-small-cell lung cancer. BMC Cancer, 2020, 20(1): 150.

1. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2. Shi JF, Wang L, Wu N, et al. Clinical characteristics and medical service utilization of lung cancer in China, 2005-2014: overall design and results from a multicenter retrospective epidemiologic survey. Lung Cancer, 2019, 128: 91-100.
3. 姚晓军, 张洪伟, 蒲强, 等. 2000 年与 2010 年四川大学华西医院收治肺癌患者的临床流行病学特征及病理类型分布特点. 四川大学学报 (医学版), 2014, 45(2): 309-315.
4. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet, 2018, 391(10125): 1023-1075.
5. 张仁锋, 张岩, 温丰标, 等. 6,058 例肺癌患者病理类型和临床流行病学特征的分析. 中国肺癌杂志, 2016, 19(3): 129-135.
6. Herbst RS, Morgensztern D, Boshoff C. The biology and management of non-small cell lung cancer. Nature, 2018, 553(7689): 446-454.
7. Travis WD, Brambilla E, Burke AP, et al. WHO classification of tumours of lung, pleura, thymus and heart. 4th ed. Lyon: IARC Press, 2015: 99-105.
8. Goldstraw P, Chansky K, Crowley J, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol, 2016, 11(1): 39-51.
9. Jemal A, Siegel R, Xu JQ, et al. Cancer statistics, 2010. CA Cancer J Clin, 2010, 60(5): 277-300.
10. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin, 2018, 68(1): 7-30.
11. Bade BC, Dela Cruz CS. Lung cancer 2020: epidemiology, etiology, and prevention. Clin Chest Med, 2020, 41(1): 1-24.
12. Alberg AJ, Brock MV, Ford JG, et al. Epidemiology of lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e1S-29S.
13. Jemal A, Miller KD, Ma J, et al. Higher lung cancer incidence in young women than young men in the United States. N Engl J Med, 2018, 378(21): 1999-2009.
14. Siegel RL, Jacobs EJ, Newton CC, et al. Deaths due to cigarette smoking for 12 smoking-related cancers in the United States. JAMA Intern Med, 2015, 175(9): 1574-1576.
15. Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review 1975-2016, updated December 11, 2019. [2020-07-01]. https://seer.cancer.gov/statistics/reports.html.
16. 中国肺癌防治联盟, 中华医学会呼吸病学分会肺癌学组, 中国医师协会呼吸医师分会肺癌工作委员会. 肺癌筛查与管理中国专家共识. 国际呼吸杂志, 2019(21): 1604-1615.
17. Okami J, Shintani Y, Okumura M, et al. Demographics, safety and quality, and prognostic information in both the seventh and eighth editions of the TNM classification in 18,973 surgical cases of the Japanese joint committee of lung cancer registry database in 2010. J Thorac Oncol, 2019, 14(2): 212-222.
18. Rami-Porta R, Bolejack V, Crowley J, et al. The IASLC lung cancer staging project: proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol, 2015, 10(7): 990-1003.
19. de Koning HJ, van der Aalst CM, de Jong PA, et al. Reduced lung-cancer mortality with volume CT screening in a randomized trial. N Engl J Med, 2020, 382(6): 503-513.
20. Wang C, Wu Y, Shao J, et al. Clinicopathological variables influencing overall survival, recurrence and post-recurrence survival in resected stage I non-small-cell lung cancer. BMC Cancer, 2020, 20(1): 150.

West China Medical Journal

Epidemiological and pathological distribution characteristics in 23 228 lung cancer patients

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