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Timeliness of Treatment Initiation and Associated Survival Following Diagnosis of Non-Small-Cell Lung Cancer in South Carolina
Journal article   Open access   Peer reviewed

Timeliness of Treatment Initiation and Associated Survival Following Diagnosis of Non-Small-Cell Lung Cancer in South Carolina

Jarrod T Bullard, Jan M Eberth, Amanda K Arrington, Swann A Adams, Xi Cheng and Ramzi G Salloum
Southern medical journal (Birmingham, Ala.), v 110(2), pp 107-113
Feb 2017
PMID: 28158880
url
https://europepmc.org/articles/pmc5492983?pdf=renderView
Accepted (AM)Open Access (License Unspecified) Open

Abstract

Adult Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - therapy Early Detection of Cancer - statistics & numerical data Female Humans Kaplan-Meier Estimate Lung Neoplasms - mortality Lung Neoplasms - pathology Lung Neoplasms - therapy Male Middle Aged Neoplasm Staging Pneumonectomy - methods Pneumonectomy - statistics & numerical data Proportional Hazards Models Radiotherapy - methods Radiotherapy - statistics & numerical data Retrospective Studies South Carolina - epidemiology Time-to-Treatment - statistics & numerical data
Non-small-cell lung cancer (NSCLC) patient survival depends on a number of factors, including early diagnosis and initiation of treatment. Standard treatment options for patients with NSCLC include surgery, radiation therapy, and chemotherapy. The objective of this study was to evaluate the impact that the initiation of timely treatment has on patient survival among a cohort of privately insured patients with NSCLC in South Carolina. Data for the study were retrospectively obtained from the South Carolina Central Cancer Registry and the state health plan Blue Cross and Blue Shield claims. Patients were diagnosed as having NSCLC between January 1, 2005 and December 31, 2010, were aged 18 years or older, and were covered under the state health plan for at least 1 year before diagnosis. The final study sample included 746 patients. Kaplan-Meier curves and Cox proportional hazard modeling were conducted to examine factors associated with survival, stratified by stage at diagnosis. The majority in the study cohort (80%) received timely (≤6 weeks) rather than untimely (>6 weeks) care (20%). The mean survival time for patients receiving timely treatment by stage was 36.9, 27.1, and 12.4 months for localized, regional, and distant metastasis, respectively. The mean survival time for patients receiving untimely care by stage was 39.4, 33.8, and 25.2 months for localized, regional, and distant metastasis, respectively. Among patients with NSCLC in the distant metastasis stage, those receiving timely treatment experienced significantly decreased survival (hazard ratio 2.2) in comparison to those receiving untimely care. Initiation of treatment within 6 weeks is not associated with greater survival time across all stages of cancer (localized, regional, and distant metastasis). Additional research is needed to examine the impact of other treatment quality metrics on the survival of patients with NSCLC, different time thresholds for treatment initiation that may be more meaningful to survival among patients with NSCLC, and timely care among patients with NSCLC in other geographic areas and populations.

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Collaboration types
Domestic collaboration
Web of Science research areas
Oncology
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