Vertaisarvioitu alkuperäisartikkeli tai data-artikkeli tieteellisessä aikakauslehdessä (A1)

Impact of sex and age on adherence to guidelines in non-small cell lung cancer management




Julkaisun tekijätPaakkola Nelly-Maria, Lindqvist Jonatan, Jekunen Antti, Sihvo Eero, Johansson Mikael, Andersén Heidi

KustantajaElsevier

Julkaisuvuosi2023

JournalCancer Treatment and Research Communications

Tietokannassa oleva lehden nimiCancer treatment and research communications

Lehden akronyymiCancer Treat Res Commun

Volyymi34

ISSN2468-2942

eISSN2468-2942

DOIhttp://dx.doi.org/10.1016/j.ctarc.2022.100675

Verkko-osoitehttps://doi.org/10.1016/j.ctarc.2022.100675

Rinnakkaistallenteen osoitehttps://research.utu.fi/converis/portal/detail/Publication/178974958


Tiivistelmä

Introduction

Age-related disparities in non-small cell lung cancer (NSCLC) treatment are well known, but few studies have assessed the impact of sex on treatment disparities. Disparities in guideline-adherence may explain the superior survival in women with NSCLC. Therefore, we aimed to define patient- and tumor-related factors associated with non-adherence to guidelines in NSCLC management with a special focus on sex and age.

Patients and Methods

Patients with NSCLC who received first-line treatment at the Vaasa Central Hospital between 2016 and 2020 were included in the study. The primary outcome was guideline adherence, defined as adherent, undertreatment, or overtreatment considering performance status. A binary logistic regression model was used to calculate the adjusted odds ratio (aOR) for non-adherence to treatment guidelines depending on patient- and tumor-related factors.

Results

321 patients were included in the study. Non-adherence was highest in ≥75-year-old women (41.3%), followed by ≥75-year-old men (32.6%), <75-year-old men (27.6%) and lowest in women <75-year-old (19.7%) (p = 0.035). Non-adherent care consisted more often of undertreatment in <75-year-old men than women (26.0% versus 12.1%) and overtreatment in <75-year-old women than men (7.6% versus 1.6%). Non-adherence was associated with stage III disease (aOR 2.21; 95% CI 1.07–4.59), poor pulmonary function (aOR 3.69, 95% CI 1.56–8.71), and Charlson Comorbidity Index 1–2 (aOR 2.09; 95% CI 1.09–4.01).

Conclusion

Sex- and age-related disparities in guideline adherence were observed in <75-year-old men and in ≥75-year-olds. Stage III NSCLC was associated with non-adherence.


Ladattava julkaisu

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Last updated on 2023-22-03 at 11:43