Clinical characteristics and medical service utilization of lung cancer in China, 2005–2014: Overall design and results from a multicenter retrospective epidemiologic survey

Ju Fang Shi*, Le Wang, Ning Wu, Jun Ling Li, Zhou Guang Hui, Shang Mei Liu, Bo Yan Yang, Shu Geng Gao, Jian Song Ren, Hui Yao Huang, Juan Zhu, Cheng Cheng Liu, Jin Hu Fan, Shi Jun Zhao, Pu Yuan Xing, Ye Zhang, Ning Li, Wen Dong Lei, De Bin Wang, Yun Chao HuangXian Zhen Liao, Xiao Jing Xing, Ling Bin Du, Li Yang, Yu Qin Liu, Yong Zhen Zhang, Kai Zhang, You Lin Qiao, Jie He, Min Dai

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

98 Citations (Scopus)

Abstract

Objectives: This study aimed to explore the clinical profile and its trajectory of lung cancer on clinicopathological characteristics and medical service utilization in China. Methods: Patients diagnosed with primary lung cancer in tertiary hospitals during 2005–14 were selected from seven geographic regions of China. Data on clinical characteristics and medical service utilization was extracted from medical record, and the ten-year trends were explored. Results: A total of 7184 patients were included, the mean age was 58.3 years and the male-to-female-ratio was 2.7. From 2005 to 2014, the proportion of ≥60 year-old patients increased from 41.2% to 56.2% (p < 0.001). The smoking rate decreased from 62.9% to 51.1% (p < 0.001) and the proportion of females increased from 23.5% to 31.9% (p < 0.001). The proportion of advanced stage increased from 41.9% to 47.4% (p < 0.001). Adenocarcinoma's proportion increased from 36.4% to 53.5% (p < 0.001) while that of squamous carcinoma decreased from 45.4% to 34.4% (p < 0.001). The application of chest X-ray dropped from 50.2% to 31.0% (p < 0.001) but that of chest CT increased from 65.8% to 81.4% (p < 0.001). As two main treatment options, chemotherapy (p = 0.290) and surgery (p = 0.497) remained stable. The medical expenditure per patient increased from 40,508 to 66,020 Chinese Yuan (p < 0.001). Conclusions: The sustaining high smoking exposure, increasing proportion of female patients, advancing clinical stage, shifting of predominant pathology and increasing medical expenditure demonstrate potential challenges and directions on lung cancer prevention and control in China. Despite substantial changes of clinical characteristics, main treatment options remained unchanged, which needs further investigation.

Original languageEnglish
Pages (from-to)91-100
Number of pages10
JournalLung Cancer
Volume128
DOIs
Publication statusPublished - Feb 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 Elsevier B.V.

Keywords

  • China
  • Clinical epidemiology
  • Lung cancer
  • Medical expenditure
  • Medical service utilization

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