Proportion of Never-Smoker Non-Small Cell Lung Cancer Patients at Three Diverse Institutions

Lorraine Pelosof, Chul Ahn, Ang Gao, Leora Horn, Alejandra Madrigales, Joan Cox, Dauphne McGavic, John D. Minna, Adi F. Gazdar, Joan Schiller

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Approximately 10% to 15% of lung cancer cases in the United States occur in never smokers, but there has been much debate about whether this rate is increasing. To determine whether the proportion of never smokers among lung cancer cases is increasing, we conducted a retrospective study using registries from The University of Texas Southwestern Medical Center, Parkland Hospital, and Vanderbilt University. Methods: Registries were queried for demographic information from 1990 to 2013 including sex, age, stage, and self-reported smoking history. Ten thousand five hundred ninety-three non-small cell lung cancer (NSCLC) case patients and 1510 small cell lung cancer (SCLC) case patients were captured, and logistic regression analysis was performed. All statistical tests were two-sided. Results: The proportion of never-smoker NSCLC patients increased from 8.0% in the years 1990 to 1995 to 14.9% in 2011 to 2013 (P <.001). This increase was also observed using multivariable logistic regression after controlling for sex, stage at diagnosis, and race/ethnicity. The percentage of never smokers among SCLC case patients (1.5% in 1990-1995 to 2.5% in 2011-2013, P =.36) or squamous cell NSCLC case patients did not statistically significantly change during this period. Conclusions: This study demonstrates an increasing proportion of NSCLC patients who have never smoked in a large, diverse patient population between 1990 and 2013. Given that this increase appears independent of sex, stage, and race/ethnicity and also occurred in our county hospital, this trend is unlikely due to changes in referral patterns and suggests that the actual incidence of lung cancer in never smokers is increasing.

Original languageEnglish (US)
Article numberdjw295
JournalJournal of the National Cancer Institute
Volume109
Issue number7
DOIs
StatePublished - Jul 1 2017

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Non-Small Cell Lung Carcinoma
Lung Neoplasms
Small Cell Lung Carcinoma
Registries
Logistic Models
County Hospitals
Referral and Consultation
Retrospective Studies
Smoking
History
Epithelial Cells
Regression Analysis
Demography
Incidence
Population

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

Cite this

Proportion of Never-Smoker Non-Small Cell Lung Cancer Patients at Three Diverse Institutions. / Pelosof, Lorraine; Ahn, Chul; Gao, Ang; Horn, Leora; Madrigales, Alejandra; Cox, Joan; McGavic, Dauphne; Minna, John D.; Gazdar, Adi F.; Schiller, Joan.

In: Journal of the National Cancer Institute, Vol. 109, No. 7, djw295, 01.07.2017.

Research output: Contribution to journalArticle

Pelosof, L, Ahn, C, Gao, A, Horn, L, Madrigales, A, Cox, J, McGavic, D, Minna, JD, Gazdar, AF & Schiller, J 2017, 'Proportion of Never-Smoker Non-Small Cell Lung Cancer Patients at Three Diverse Institutions', Journal of the National Cancer Institute, vol. 109, no. 7, djw295. https://doi.org/10.1093/jnci/djw295
Pelosof, Lorraine ; Ahn, Chul ; Gao, Ang ; Horn, Leora ; Madrigales, Alejandra ; Cox, Joan ; McGavic, Dauphne ; Minna, John D. ; Gazdar, Adi F. ; Schiller, Joan. / Proportion of Never-Smoker Non-Small Cell Lung Cancer Patients at Three Diverse Institutions. In: Journal of the National Cancer Institute. 2017 ; Vol. 109, No. 7.
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abstract = "Background: Approximately 10{\%} to 15{\%} of lung cancer cases in the United States occur in never smokers, but there has been much debate about whether this rate is increasing. To determine whether the proportion of never smokers among lung cancer cases is increasing, we conducted a retrospective study using registries from The University of Texas Southwestern Medical Center, Parkland Hospital, and Vanderbilt University. Methods: Registries were queried for demographic information from 1990 to 2013 including sex, age, stage, and self-reported smoking history. Ten thousand five hundred ninety-three non-small cell lung cancer (NSCLC) case patients and 1510 small cell lung cancer (SCLC) case patients were captured, and logistic regression analysis was performed. All statistical tests were two-sided. Results: The proportion of never-smoker NSCLC patients increased from 8.0{\%} in the years 1990 to 1995 to 14.9{\%} in 2011 to 2013 (P <.001). This increase was also observed using multivariable logistic regression after controlling for sex, stage at diagnosis, and race/ethnicity. The percentage of never smokers among SCLC case patients (1.5{\%} in 1990-1995 to 2.5{\%} in 2011-2013, P =.36) or squamous cell NSCLC case patients did not statistically significantly change during this period. Conclusions: This study demonstrates an increasing proportion of NSCLC patients who have never smoked in a large, diverse patient population between 1990 and 2013. Given that this increase appears independent of sex, stage, and race/ethnicity and also occurred in our county hospital, this trend is unlikely due to changes in referral patterns and suggests that the actual incidence of lung cancer in never smokers is increasing.",
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AU - Ahn, Chul

AU - Gao, Ang

AU - Horn, Leora

AU - Madrigales, Alejandra

AU - Cox, Joan

AU - McGavic, Dauphne

AU - Minna, John D.

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N2 - Background: Approximately 10% to 15% of lung cancer cases in the United States occur in never smokers, but there has been much debate about whether this rate is increasing. To determine whether the proportion of never smokers among lung cancer cases is increasing, we conducted a retrospective study using registries from The University of Texas Southwestern Medical Center, Parkland Hospital, and Vanderbilt University. Methods: Registries were queried for demographic information from 1990 to 2013 including sex, age, stage, and self-reported smoking history. Ten thousand five hundred ninety-three non-small cell lung cancer (NSCLC) case patients and 1510 small cell lung cancer (SCLC) case patients were captured, and logistic regression analysis was performed. All statistical tests were two-sided. Results: The proportion of never-smoker NSCLC patients increased from 8.0% in the years 1990 to 1995 to 14.9% in 2011 to 2013 (P <.001). This increase was also observed using multivariable logistic regression after controlling for sex, stage at diagnosis, and race/ethnicity. The percentage of never smokers among SCLC case patients (1.5% in 1990-1995 to 2.5% in 2011-2013, P =.36) or squamous cell NSCLC case patients did not statistically significantly change during this period. Conclusions: This study demonstrates an increasing proportion of NSCLC patients who have never smoked in a large, diverse patient population between 1990 and 2013. Given that this increase appears independent of sex, stage, and race/ethnicity and also occurred in our county hospital, this trend is unlikely due to changes in referral patterns and suggests that the actual incidence of lung cancer in never smokers is increasing.

AB - Background: Approximately 10% to 15% of lung cancer cases in the United States occur in never smokers, but there has been much debate about whether this rate is increasing. To determine whether the proportion of never smokers among lung cancer cases is increasing, we conducted a retrospective study using registries from The University of Texas Southwestern Medical Center, Parkland Hospital, and Vanderbilt University. Methods: Registries were queried for demographic information from 1990 to 2013 including sex, age, stage, and self-reported smoking history. Ten thousand five hundred ninety-three non-small cell lung cancer (NSCLC) case patients and 1510 small cell lung cancer (SCLC) case patients were captured, and logistic regression analysis was performed. All statistical tests were two-sided. Results: The proportion of never-smoker NSCLC patients increased from 8.0% in the years 1990 to 1995 to 14.9% in 2011 to 2013 (P <.001). This increase was also observed using multivariable logistic regression after controlling for sex, stage at diagnosis, and race/ethnicity. The percentage of never smokers among SCLC case patients (1.5% in 1990-1995 to 2.5% in 2011-2013, P =.36) or squamous cell NSCLC case patients did not statistically significantly change during this period. Conclusions: This study demonstrates an increasing proportion of NSCLC patients who have never smoked in a large, diverse patient population between 1990 and 2013. Given that this increase appears independent of sex, stage, and race/ethnicity and also occurred in our county hospital, this trend is unlikely due to changes in referral patterns and suggests that the actual incidence of lung cancer in never smokers is increasing.

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