Survival with lung cancer in Finland has not improved during 2007–2019–a single center retrospective population-based real-world study

Figures & data

Table 1. Comparison between the cohorts in terms of the distribution of the prognostic factors of lung cancer (N = 3041).

Cohort	2007–2012 (n = 1304)	2013–2019 (n = 1737)	p Value
Age, years, median (IQR)	70.4 (15.0)	71.4 (12.9)	<.001*
Gender, n (%)
Male	878 (67.3)	1108 (63.8)	.045**
Female	426 (32.7)	629 (36.2)
Stage, n (%)
I	155 (14.7)	236 (16.1)	.21^†
II	71 (6.7)	102 (6.9)
III	220 (20.8)	258 (17.6)
IV	611 (57.8)	874 (59.5)
Unknown	247 (18.9)	267 (15.4)
Histology, n (%)
Adenocarcinoma	418 (32.1)	714 (41.1)	<.001^†
Squamous cell carcinoma	310 (23.8)	381 (21.9)
Small cell carcinoma	162 (12.4)	232 (13.4)
NSCLC NOS	115 (8.8)	145 (8.3)
Carcinoid	23 (1.8)	43 (2.5)
Other	69 (5.3)	67 (3.9)
Clinical diagnosis	207 (15.9)	155 (8.9)
PS (ECOG), n (%)
0–1	510 (55.3)	578 (44.4)	<.001^†
2	263 (28.5)	366 (28.1)
3–4	149 (16.2)	359 (27.6)
Unknown	382 (29.3)	434 (25.0)
Smoking status, n (%)
Never	180 (14.7)	265 (15.5)	.70^†
Former	495 (40.3)	665 (39.0)
Current	553 (45.0)	776 (45.5)
Unknown	76 (5.8)	31 (1.8)
Mutation status, n (%)
No/unknown	1285 (98.5)	1670 (96.1)	<.001**
Mutated	19 (1.5)	67 (3.9)
CCI, n (%)
0	779 (59.7)	882 (50.8)	<.001^†
1–2	376 (28.8)	499 (28.7)
3–4	73 (5.6)	180 (10.4)
5 or more	76 (5.8)	176 (10.1)

CCI: Charlson Comorbidity Index; ECOG: Eastern Cooperative Oncology Group; IQR: interquartile range; NOS: not otherwise specified; NSCLC: non-small-cell lung carcinoma; PS: performance status.

* Mann–Whitney U-test.

** Fisher’s exact test, two-sided.

^† Chi-squared test.

Figure 1. Annual incidence and all-cause 5-year mortality rates (per 100,000) of lung cancer. n = annual number of new lung cancer patients. *Follow-up time is less than 5 years.

Figure 2. Kaplan–Meier’s curves for overall survival in both subcohorts.

Table 2. The effects of prognostic factors on the risk of death (all causes): results of the multivariable-adjusted Cox regression analysis.

	2007–2012 (n = 1300^a)			2013–2019 (n = 1734^a)
Subcohort	HR (95% CI)		p Value	HR (95% CI)		p Value
Age	1.02 (1.02–1.03)		<.001	1.02 (1.01–1.03)		<.001
Gender
Female	1			1
Male	1.25 (1.09–1.43)		.002	1.24 (1.09–1.40)		<.001
Stage
I	1		<.001	1		<.001
II	1.66 (1.19–2.32)		.003	2.37 (1.63–3.44)		<.001
III	3.07 (2.40–3.93)		<.001	5.38 (4.02–7.18)		<.001
IV	5.75 (4.59–7.19)		<.001	10.6 (8.18–13.6)		<.001
Unknown	1.74 (1.36–2.22)		<.001	4.16 (3.16–5.49)		<.001
Histology
Squamous cell carcinoma	1		<.001	1		<.001
Adenocarcinoma	0.94 (0.79–1.11)		.4	0.99 (0.85–1.16)		.9
NSCLC NOS	1.24 (0.99–1.55)		.07	1.29 (1.05–1.60)		.02
Small cell carcinoma	1.57 (1.28–1.94)		<.001	1.24 (1.03–1.50)		.03
Carcinoid	0.28 (0.13–0.60)		.001	0.18 (0.09–0.34)		<.001
Other	1.16 (0.88–1.54)		.3	0.97 (0.71–1.32)		.8
Clinical diagnosis	0.87 (0.71–1.07)		.2	0.72 (0.57–0.91)		.005
PS (ECOG)
0–1	1		<.001	1		<.001
2	1.54 (1.31–1.80)		<.001	1.47 (1.25–1.72)		<.001
3–4	2.26 (1.85–2.75)		<.001	2.80 (2.38–3.31)		<.001
Unknown	2.13 (1.80–2.50)		<.001	3.43 (2.86–4.12)		<.001
Smoking status
Former	1		<.001	1		<.001
Current	1.06 (0.93–1.21)		.4	1.16 (1.02–1.31)		.03
Never	0.89 (0.72–1.10)		.3	0.66 (0.53–0.81)		<.001
Unknown	1.73 (1.33–2.25)		<.001	1.00 (0.66–1.53)		1.0
Mutation status
No/unknown	1			1
Yes	0.74 (0.44–1.24)		.3	0.57 (0.41–0.78)		<.001
CCI
0	1		.001	1		.003
1–2	1.20 (1.05–1.37)		.007	0.94 (0.82–1.08)		.4
3–4	1.25 (0.97–1.61)		.08	1.08 (0.89–1.31)		.4
5 or more	1.50 (1.17–1.92)		.001	1.36 (1.13–1.63)		.001

ECOG: Eastern Cooperative Oncology Group; CCI: Charlson Comorbidity Index; CI: confidence interval; HR: hazard ratio; NOS: not otherwise specified; NSCLC: non-small-cell lung cancer; PS: performance status.

^aSeven patients were excluded from the survival analysis due to negative survival times.

Data availability statement

The data that support the findings of this study are available from the corresponding author (JA) upon reasonable request.