PATIENT CARE EVALUATION OF NON-SMALL CELL LUNG CARCINOMA DATA YEAR: 2001

REVIEWING PHYSICIAN: JAVIER CORRAL, MD

DATA COLLECTOR: SANDRA JAQUEZ, CANCER REGISTRAR, CTR

PURPOSE:

This study of non-small cell lung carcinoma is being conducted to document current types of patient presentation, diagnostic methodology, radiologic work-up, and treatment information.

ELIGIBILITY:

Patients entered into this study have a microscopically confirmed primary of non-small cell carcinoma of the lung. Cases were classified as a non-small cell malignancy that was either diagnosed and/or initially treated at Del Sol Medical Center (class of case 1 and 2.) Cases entered into this study are consecutive hospital or clinic admissions.

FINDINGS:

Total Cases Reviewed: 43

Patient gender: male = 58%, female = 42% (see Graph 3.)

Ethnicity: Hispanic = 74%, Caucasian = 26%, Black = 0%, Other = 0%

Age at diagnosis: 31% were less than 70 years old (see Graph 1.)

Most common symptoms at diagnosis: cough (59%), shortness of breath (40%), and weight loss (49%) - (see Graph 7.)

A total of 74% of all study patients have a history of smoking (see Graph 8.)

Most common patient co-morbidity: hypertension (26%) - (see Graph 6.)

Seventy-six percent of study patients diagnosed at stage of disease III or IV (see Graph 2.)

FINAL CONCLUSIONS:

Ten percent (10%) of the study patients are under 60 years of age, and 21% are under age 70 (see Graph 1.) Ethnicity in this study group is representative of the El Paso community.

A high percentage of these patients were diagnosed at a late stage of disease, 76% were diagnosed at Stage III or IV (see graph 2.) This late stage of disease contributed to the high patient mortality rate (67%.) (Please see Graphs 4-5 & Table 1 for more survival/mortality related information.) Cancer Facts and Figures, 2001 indicates that, "the survival rate is 49% for cases detected when the disease is still localized, but only 15% of lung cancers are discovered that early."

Patient smoking history indicates a pattern of tobacco use beginning at an early age. Twenty-four percent (24%) of study patients have a smoking history of 40 years or more. A total of 74% of all patients have a history of smoking, 19% have no history of tobacco use, and 7% have no documentation regarding their tobacco use history (see Graph 8.)

Radiologic work up at diagnosis consisted of chest x-rays (100%), CT of the chest (100%) & brain (81%), MRI of the chest (2%) & brain (40%), bone scan (95%), and bronchoscopy (79%.)

Main treatment modalities were surgery (1%), chemotherapy (30%), and radiation therapy (58%). Ten percent (10%) of the study patients received no treatment at initial diagnosis.

RECOMMENDATIONS:

All of these conclusions indicate a strong need for lung cancer awareness and education in the El Paso area.

• Alert physicians in the El Paso medical community of the results of this study and encourage them to follow closely those patients who have any amount of smoking history.

• Educate the public that the symptoms listed above, can be indicative of lung cancer in those people who have a smoking history and that they should not wait to consult a physician when experiencing any of these symptoms.
  • Establish a permanent lung cancer information display for the Kiosk at the Cielo Vista Mall.
  • Insure that lung cancer related and smoking prevention/cessation information is included at local community health fairs.

• DSMC Cancer Program participation in the November 2002 Great American Smoke Out.
  • Related activities to be carried at both the hospital and the Cielo Vista Mall kiosk.

• Send a copy of this study with a letter of congratulations to the city government of El Paso for enforcing the citywide non-smoking ordinance for all public buildings. This ordinance went into effect January 2002.