Cancer
Lung Cancer Survival in Texas: Analyzing Histological Subtypes and Sociodemographic Influences Dalila Coimbra* Dalila Caroline do Amaral Coimbra Natalie Archer Paige Miller
Introduction
Lung cancer represents a significant public health challenge in Texas. In 2022, 13,482 new cases were reported. It remains the leading cause of cancer mortality in the state, with a poor survival rate of approximately 24%. Despite advancements, disparities persist across different histologic subtypes and demographic factors.
Methods
This study analyzed survival trends for 175,540 patients from the Texas Cancer Registry aged 20 years and older diagnosed with lung cancer between 2007 and 2020, followed through 2021. We examined survival rates stratified by sex, race, geographic region, insurance status, and lung cancer histological subtype. Statistical analyses included 5-year observed and relative cancer survival using SEER*Stat, survival trend analysis using JPSurv, and Cox proportional hazards survival regression model using SAS.
Results
Lung cancer 5-year relative survival (RS) was 22.1% (Annual Average Change [AAC]=0.64). Non-Small Cell Lung Carcinoma (NSCLC) adenocarcinoma had a RS of 29.2% (AAC=0.82), while NSCLC squamous RS was only 20.2% (AAC=0.43). Women had higher RS (25.7%) than men (18.8%). Racial disparities were evident; non-Hispanic blacks had the lowest RS (20.4%). Geographic analysis revealed the lowest RS rates in North Texas (16.9%) and the highest in South Texas, near San Antonio (34.7%). Uninsured patients had a RS of 21.6% (AAC=0.84) and privately insured 29.9% (AAC=1.35). Cox regression indicated that histological type, race/ethnicity, year of diagnosis, sex, cancer stage at diagnosis, and insurance type significantly affected survival (p<0.05).
Discussion
Findings highlight significant differences in lung cancer survival based on several demographic and socioeconomic factors. These results emphasize the need for targeted interventions and policies to improve access to care and address social determinants.
Conclusion
This study underscores the multifaceted nature of lung cancer survival in Texas, necessitating a comprehensive approach.