Initial medical attention on patients with early-stage non-small cell lung cancer

• Published in: PloS one Vol. 7; no. 3; p. e32644
• Main Authors: Chen, Xing, Gorlov, Ivan P, Ying, Jun, Merriman, Kelly W, Kimmel, Marek, Lu, Charles, Reyes-Gibby, Cielito C, Gorlova, Olga Y
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 07.03.2012; Public Library of Science (PLoS)
• Subjects: Aged; Aged, 80 and over; Analysis; Biology; Cancer; Cancer research; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - mortality; Diagnosis; Electronic health records; Epidemiology; Female; Gender; Health aspects; Health risk assessment; Humans; Lung cancer; Lung diseases; Lung Neoplasms - diagnosis; Lung Neoplasms - mortality; Male; Medical diagnosis; Medical records; Medical screening; Medicine; Middle Aged; Mortality; Neoplasm Staging; Non-small cell lung cancer; Non-small cell lung carcinoma; Ovarian cancer; Patients; Primary care; Prognosis; Registries; Retrospective Studies; Small cell lung cancer; Smoking; Survival; Tumor Burden; Womens health; United States > US; Texas
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0032644

Detection of early stage non-small cell lung cancer (NSCLC) is commonly believed to be incidental. Understanding the reasons that caused initial detection of these patients is important for early diagnosis. However, these reasons are not well studied. We retrospectively reviewed medical records of patients diagnosed with stage I or II NSCLC between 2000 and 2009 at UT MD Anderson Cancer Center. Information on suggestive LC-symptoms or other reasons that caused detection were extracted from patients' medical records. We applied univariate and multivariate analyses to evaluate the association of suggestive LC-symptoms with tumor size and patient survival. Of the 1396 early stage LC patients, 733 (52.5%) presented with suggestive LC-symptoms as chief complaint. 347 (24.9%) and 287 (20.6%) were diagnosed because of regular check-ups and evaluations for other diseases, respectively. The proportion of suggestive LC-symptom-caused detection had a linear relationship with the tumor size (correlation 0.96; with p<.0001). After age, gender, race, smoking status, therapy, and stage adjustment, the symptom-caused detection showed no significant difference in overall and LC-specific survival when compared with the other (non-symptom-caused) detection. Symptoms suggestive of LC are the number one reason that led to detection in early NSCLC. They were also associated with tumor size at diagnosis, suggesting early stage LC patients are developing symptoms. Presence of symptoms in early stages did not compromise survival. A symptom-based alerting system or guidelines may be worth of further study to benefit NSCLC high risk individuals.