https://scholars.lib.ntu.edu.tw/handle/123456789/624335
標題: | Stage Shift Improves Lung Cancer Survival: Real-World Evidence | 作者: | CHING-YAO YANG YEN-TING LIN Lin, Li Ju Chang, Ya Hsuan Chen, Hsuan Yu Wang, Yi Pin JIN-YUAN SHIH CHONG-JEN YU PAN-CHYR YANG |
關鍵字: | Five-year survival | Low-dose computed tomography | Lung cancer screening | Stage shift | 公開日期: | 一月-2023 | 來源出版物: | Journal of Thoracic Oncology | 摘要: | Introduction: Lung cancer is the global leading cause of cancer death. Taiwan initiated several health policies including smoking cessation, precision therapy, and low-dose computed tomography (LDCT) screening in 1997. We aimed to investigate the effect of public policies on lung cancer survival. Methods: We retrieved the nationwide cancer registry from the Ministry of Health and Welfare to evaluate the smoking prevalence and lung cancer incidence and mortality from 1994 to 2020. We also conducted a retrospective analysis of clinical characteristics and survival on 17,298 patients with lung cancer from 2006 to 2019 using the National Taiwan University Hospital database. Results: Taiwan initiated an anti-smoking campaign in 1997, reimbursed tyrosine kinase inhibitors since 2004, and conducted an LDCT screening trial in 2015. Lung cancer incidence keeps rising but the annual percent change in mortality rate gradually decreased from 0.41% to −2.41%. The National Taiwan University Hospital data revealed that the 5-year survival substantially improved from 22.1% in 2006 to 2011 to 54.9% in 2015 to 2020. Improvement was observed in all stages, especially late stages (stage III: from 17.2% to 35.2%; stage IV: from 7.9% to 16.5%). Furthermore, a remarkable shift in cancer stage was observed (stage 0, I, and IIincreased from 19.3% to 62.8%, and stage III and IV decreased from 70.9% to 33.8%). The prominent improvement in survival was primarily driven by the stage shift from advanced to localized, potentially curable disease. Conclusions: This real-world evidence suggested an association between improved survival and LDCT screening and the diagnostic shift from late to early-stage of lung cancer, highlighting the importance of early detection for lung cancer control. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/624335 | ISSN: | 15560864 | DOI: | 10.1016/j.jtho.2022.09.005 |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。