Comparison of demographic characteristics, surgical resection patterns, and survival outcomes for veterans and nonveterans with non-small cell lung cancer in the Pacific Northwest.

Published

Journal Article

INTRODUCTION: Lung cancer is a leading cause of death in the United States and among veterans. This study compares patterns of diagnosis, treatment, and survival for veterans diagnosed with non-small cell lung cancer (NSCLC) using a recently established cancer registry for the Veterans Affairs Pacific Northwest Network with the Puget Sound Surveillance, Epidemiology, and End Results cancer registry. METHODS: A cohort of 1715 veterans with NSCLC were diagnosed between 2000 and 2006, and 7864 men were diagnosed in Washington State during the same period. Demographics, tumor characteristics, initial surgical patterns, and survival across the two registries were evaluated. RESULTS: Veterans were more likely to be diagnosed with stage I or II disease (32.8%) compared with the surrounding community (21.5%, p = 0.001). Surgical resection rates were similar for veterans (70.2%) and nonveterans (71.2%) older than 65 years with early-stage disease (p = 0.298). However, veterans younger than 65 years with early-stage disease were less likely to undergo surgical resection (83.3% versus 91.5%, p = 0.003). Because there were fewer late-stage patients among veterans, overall survival was better, although within each stage group veterans experienced worse survival compared with community patients. The largest differences were among early-stage patients with 44.6% 5-year survival for veterans compared with 57.4% for nonveterans (p = 0.004). CONCLUSIONS: The use of surgical resection among younger veterans with NSCLC may be lower compared with the surrounding community and may be contributing to poorer survival. Cancer quality of care studies have primarily focused on patients older than 65 years using Medicare claims; however, efforts to examine care for younger patients within and outside the Department of Veterans Affairs are needed.

Full Text

Duke Authors

Cited Authors

  • Zeliadt, SB; Sekaran, NK; Hu, EY; Slatore, CC; Au, DH; Backhus, L; Wu, DY; Crawford, J; Lyman, GH; Dale, DC

Published Date

  • October 2011

Published In

Volume / Issue

  • 6 / 10

Start / End Page

  • 1726 - 1732

PubMed ID

  • 21857253

Pubmed Central ID

  • 21857253

Electronic International Standard Serial Number (EISSN)

  • 1556-1380

Digital Object Identifier (DOI)

  • 10.1097/JTO.0b013e31822ada77

Language

  • eng

Conference Location

  • United States