ALBANY, NY—How does the epidemiology of lung cancer differ in the VHA compared to the general population?
That was the question raised by a recent study that noted that lung carcinoids (LC) “continue to increase in prevalence and existing data shows a female predominance of these tumors, but relevant epidemiologic data for heterogeneous populations is limited.”
A lung carcinoid tumor is a type of cancerous tumor that consists of neuroendocrine cells. Found throughout the body, including the lungs, they are similar to endocrine cells because both produce hormones or hormone-like substances.
In a presentation at the recent American Society of Clinical Oncology (ASCO) annual meeting in Chicago, the researchers sought to describe the epidemiology of LC in the U.S. veteran population.1
For the retrospective study, the authors from the Albany, NY, and the Albany VAMC searched the VA Cancer Cube Registry (VACCR) for LC cases diagnosed between 2000 and 2017 and their baseline characteristics. The study team analyzed survival rates across all baseline characteristics to identify important prognostic factors. They then compared results with the Surveillance, Epidemiology, and End Results cancer database (SEER).
Ultimately, 846 LC cases were identified in the VACCR (91% males), with 8,851 identified in SEER (32% males).
“Compared to SEER, VACCR data had more black patients (12% vs 8%), less cases with loco-regional disease (56% vs 84% in SEER) and the same proportion of lower lobe tumors (40%),” the authors wrote.
The study pointed out that the annual incidence rate of LC among all lung cancers in veterans tripled from 2000 to 2017 (0.3% to 0.9%). No racial disparities in treatment were noted among the veterans.
The researchers also advised that the male-specific 5-year survival rate was 18% lower in VACCR compared to SEER (61% vs 79%). Their analysis demonstrated a statistically significant association of survival with age, primary tumor site and gender, while advanced age, upper lobe LC and male gender were all associated with worse survival.
SEER subgroup analyses also showed lower 5-year survival rates for males across all baseline characteristics.
“Overall, black race appeared to be associated with worse prognosis, but the results did not reach statistical significance for VACCR data,” the study added.
The authors concluded that their study “showed that the U.S. veteran population, consisting of older males with more comorbidities, LC have lower survival rates than SEER population with more female LC cases. Advanced age, upper lobe predominant disease, and advanced stage were associated with worse survival. Both SEER and VACCR data suggest that male sex is a poor prognostic factor for LC.”
- Tehzeeb J, Mahmood F, Gemoets D, Azem A, Mehdi SA. Epidemiology and survival trends of lung carcinoids in the veteran population.2023 ASCO annual meeting. June 2-6, 2023. J Clin Oncol 41, 2023 (suppl 16; abstr e21049)
