How does autoimmune disease impact treatment and outcomes among patients with lung cancer? A national SEER-Medicare analysis

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5 Citations (Scopus)

Abstract

Background The advent of cancer immunotherapy has made autoimmune disease in oncology populations clinically important. We analyzed the association of autoimmune disease with treatment and outcomes among lung cancer patients. Methods Using linked Surveillance Epidemiology and End Results (SEER)-Medicare data, we identified lung cancer patients diagnosed between 1992 and 2009 with autoimmune diseases. We recorded number and timing of autoimmune disease diagnoses, lung cancer treatment, and markers of healthcare utilization including emergency department visits, hospitalizations, and outpatient visits. To account for potential lead-time bias, we used a matched case-control analysis wherein living and deceased patients were matched on survival time. We performed unadjusted and multivariable adjusted logistic regressions separately by cancer stage for all-cause and lung cancer-specific mortality. Results Among 172,285 lung cancer patients, 23,084 (13.4%) had ≥1 autoimmune disease at any time. Overall, 10,927 patients (6.3%) had one autoimmune disease before cancer diagnosis; 9338 (5.4%) had two or more before cancer diagnosis; and 2819 (1.6%) had one or more after cancer diagnosis. Healthcare utilization was higher in the autoimmune disease population. Lung cancer treatment patterns were similar among patients with and without autoimmune disease and there was no significant association with mortality. Conclusions Among patients with lung cancer, autoimmune disease does not influence treatment patterns and is not associated with mortality.

Original languageEnglish (US)
Pages (from-to)97-102
Number of pages6
JournalLung Cancer
Volume115
DOIs
StatePublished - Jan 1 2018

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Medicare
Autoimmune Diseases
Lung Neoplasms
Epidemiology
Neoplasms
Mortality
Delivery of Health Care
Immunotherapy
Population
Hospital Emergency Service
Hospitalization
Outpatients
Therapeutics
Logistic Models
Survival

Keywords

  • Autoimmune disease
  • Immune therapy
  • Lung cancer
  • SEER-medicare

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

@article{66b98fa6a30e456d9769e1796c039e19,
title = "How does autoimmune disease impact treatment and outcomes among patients with lung cancer? A national SEER-Medicare analysis",
abstract = "Background The advent of cancer immunotherapy has made autoimmune disease in oncology populations clinically important. We analyzed the association of autoimmune disease with treatment and outcomes among lung cancer patients. Methods Using linked Surveillance Epidemiology and End Results (SEER)-Medicare data, we identified lung cancer patients diagnosed between 1992 and 2009 with autoimmune diseases. We recorded number and timing of autoimmune disease diagnoses, lung cancer treatment, and markers of healthcare utilization including emergency department visits, hospitalizations, and outpatient visits. To account for potential lead-time bias, we used a matched case-control analysis wherein living and deceased patients were matched on survival time. We performed unadjusted and multivariable adjusted logistic regressions separately by cancer stage for all-cause and lung cancer-specific mortality. Results Among 172,285 lung cancer patients, 23,084 (13.4{\%}) had ≥1 autoimmune disease at any time. Overall, 10,927 patients (6.3{\%}) had one autoimmune disease before cancer diagnosis; 9338 (5.4{\%}) had two or more before cancer diagnosis; and 2819 (1.6{\%}) had one or more after cancer diagnosis. Healthcare utilization was higher in the autoimmune disease population. Lung cancer treatment patterns were similar among patients with and without autoimmune disease and there was no significant association with mortality. Conclusions Among patients with lung cancer, autoimmune disease does not influence treatment patterns and is not associated with mortality.",
keywords = "Autoimmune disease, Immune therapy, Lung cancer, SEER-medicare",
author = "Khan, {Saad A.} and Pruitt, {Sandi L.} and Lei Xuan and Una Makris and Gerber, {David E.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.lungcan.2017.11.024",
language = "English (US)",
volume = "115",
pages = "97--102",
journal = "Lung Cancer",
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publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - How does autoimmune disease impact treatment and outcomes among patients with lung cancer? A national SEER-Medicare analysis

AU - Khan, Saad A.

AU - Pruitt, Sandi L.

AU - Xuan, Lei

AU - Makris, Una

AU - Gerber, David E.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background The advent of cancer immunotherapy has made autoimmune disease in oncology populations clinically important. We analyzed the association of autoimmune disease with treatment and outcomes among lung cancer patients. Methods Using linked Surveillance Epidemiology and End Results (SEER)-Medicare data, we identified lung cancer patients diagnosed between 1992 and 2009 with autoimmune diseases. We recorded number and timing of autoimmune disease diagnoses, lung cancer treatment, and markers of healthcare utilization including emergency department visits, hospitalizations, and outpatient visits. To account for potential lead-time bias, we used a matched case-control analysis wherein living and deceased patients were matched on survival time. We performed unadjusted and multivariable adjusted logistic regressions separately by cancer stage for all-cause and lung cancer-specific mortality. Results Among 172,285 lung cancer patients, 23,084 (13.4%) had ≥1 autoimmune disease at any time. Overall, 10,927 patients (6.3%) had one autoimmune disease before cancer diagnosis; 9338 (5.4%) had two or more before cancer diagnosis; and 2819 (1.6%) had one or more after cancer diagnosis. Healthcare utilization was higher in the autoimmune disease population. Lung cancer treatment patterns were similar among patients with and without autoimmune disease and there was no significant association with mortality. Conclusions Among patients with lung cancer, autoimmune disease does not influence treatment patterns and is not associated with mortality.

AB - Background The advent of cancer immunotherapy has made autoimmune disease in oncology populations clinically important. We analyzed the association of autoimmune disease with treatment and outcomes among lung cancer patients. Methods Using linked Surveillance Epidemiology and End Results (SEER)-Medicare data, we identified lung cancer patients diagnosed between 1992 and 2009 with autoimmune diseases. We recorded number and timing of autoimmune disease diagnoses, lung cancer treatment, and markers of healthcare utilization including emergency department visits, hospitalizations, and outpatient visits. To account for potential lead-time bias, we used a matched case-control analysis wherein living and deceased patients were matched on survival time. We performed unadjusted and multivariable adjusted logistic regressions separately by cancer stage for all-cause and lung cancer-specific mortality. Results Among 172,285 lung cancer patients, 23,084 (13.4%) had ≥1 autoimmune disease at any time. Overall, 10,927 patients (6.3%) had one autoimmune disease before cancer diagnosis; 9338 (5.4%) had two or more before cancer diagnosis; and 2819 (1.6%) had one or more after cancer diagnosis. Healthcare utilization was higher in the autoimmune disease population. Lung cancer treatment patterns were similar among patients with and without autoimmune disease and there was no significant association with mortality. Conclusions Among patients with lung cancer, autoimmune disease does not influence treatment patterns and is not associated with mortality.

KW - Autoimmune disease

KW - Immune therapy

KW - Lung cancer

KW - SEER-medicare

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