Lung cancer accounted for 16% of cases seen at St. Anthony's Hospital between 2000-2009, similar to the national average of 14.8%. The incidence of lung cancer has been stable over the last decade. Non-small cell lung cancer (NSCLC) made up 86% of cases, while small cell lung cancer (SCLC) was 14%. Stage distribution and patient demographics like age and race were comparable to national data. Survival rates were also similar to national figures and reflect the generally poor prognosis of lung cancer. The percentage of identified smokers among lung cancer patients has decreased slightly over the past 10 years. Non-smokers had superior survival outcomes compared to smokers.

1. Lung Cancer at St. Anthony’s Hospital 2000-2009 with Comparisons with the National Cancer Data Base Lung cancer is the second most common cancer seen at St. Anthony’s (SAH) and accounted for 16% of analytic cases in 2009. Nationally lung cancer accounted for 14.8% of all cases. The incidence of this disease has been stable over the last ten years as noted in figure 1.

2. Figure 1

3. Small cell carcinoma (SCL) accounted for 14% of the histological types and Non-Small cell (NSCL) for 86% as show in figure 2. In the NCDB NSCL accounted for 84% and SCL 16%. Figure 2

4. The race and age distribution are as noted in figures 3 and 4 and are similar to the distribution from the corresponding National Cancer Data Base (NCDB). Figure 3

5. Figure 4

6. Stage distribution and comparisons are as noted. Patient with lung cancer are rarely diagnosed in early stages and for NSCL only 24% were stage I/II and for SCL only 13%. See figures 5 and 6 Figure 5

7. Figure 6

8. Survival is similar to NCDB (figures 7 and 8) and reflects the poor outcome of this cancer. Figure 7

9. Figure 8

10. The frequency of smoking has been declining for many years and SAH became a completely smoke free campus in 2010. We looked to see if the percent of lung cancer patients identified as smokers has changed over the last ten years and if this affected their prognosis.

11. Smoking Distribution by Gender and Histology During the period 2000-2005 16% of the NSCL patients were non-smokers and this number increased to 19% in 2009. With SCL 6% were non-smokers during 2000-2005 and this number rose to 21% in 2009. The details by gender and histology are as noted in figure 9. Figure 9 17% 4% 12% 9% Female 4% 2% 7% 7% Male Non-smoker 33% 44% 43% 41% Female 46% 50% 39% 43% Male Smoker 2009 2000-05 2009 2000-05 SCL NSCL

12. The outcome for non-smokers was superior to smokers. The 5 year relative survival for NSCL rose from 10.4% (smokers) to 16.3% (non-smokers). For SCL patients the survival was also much better, 5.13% (smokers) and 37.2% (non-smokers), see figure 10. Figure 10