Hi, my name is Chelsea Furtzahadzada, and this presentation is on our project entitled The Impact of Sex on Non-Small-Cell Lung Cancer Survival in Canada. I have no financial relationships to disclose. Lung cancer has a high incidence and low survival, and is the leading cause of cancer-related death in Canada. Non-small-cell lung cancer accounts for approximately 88% of all lung cancer cases. Studies from outside of Canada have shown differences in non-small-cell lung cancer survival by sex, with females having better overall survival than males, and this has not been explained by differences in age, smoking history, or diagnosis stage. There has yet to be a thorough examination of the role of sex in the survival of this disease within Canada, so the objective of this project was to complete preliminary analyses to evaluate the impact of sex on survival in a population-based cohort of patients with non-small-cell lung cancer. The data used in this project is a cohort from the GLAND Look Lung Cancer Database. This database includes a large amount of demographic and health information on all patients who are diagnosed with lung cancer in the province of Alberta. The specific cohort analyzed included all patients with a non-small-cell diagnosis in the province between 2010 and 2017. As seen in Table 1, there were approximately equal numbers of male and female patients. Basic descriptive statistics indicate around 50% of patients were diagnosed at stage 4 cancer, and adenocarcinoma, squamous cell carcinoma, and pathologically not otherwise specified were the most common histological subtypes. The median overall survival was 15.2 months for females and 10.9 months for males, and 72% of female patients and 81% of male patients passed away during the study period. To compare survival between the different subgroups of males and females, we used Kaplan-Meier estimators with log-rank tests. Patients with missing data were excluded, and a p-value of less than 0.05 was considered significant. The first subgroups that we compared were males and females at each stage of diagnosis. Looking at the survival curves, the solid lines representing the female groups had consistently better survival probability than their male counterparts within each stage. The log-rank tests support this, and we found that females had significantly longer survival than males across stages of diagnosis. The next subgroups that we compared were males and females within the three most common histological subgroups, again, the adenocarcinoma, squamous cell carcinoma, and pathologically not otherwise specified cases. Again, with females represented by solid lines, the survival curves indicate better survival probability in females than males in each subgroup. The significant log-rank tests across the groups show that in each non-small cell lung cancer subtype, females had significantly longer survival than males. Finally, we compared male and female survival within each stage of the common subtypes. For adenocarcinoma, females had significantly longer survival in all stages of diagnosis. For squamous cell carcinoma, females only had a significant survival advantage among those who were stage one at diagnosis. For the not otherwise specified subtype group, females had a significantly longer survival in those who were diagnosed at stage four, but there was no other differences across the stages. The take-home messages from these preliminary analyses are that females had a significantly longer survival than males at all stages of non-small cell lung cancer diagnosis in Alberta, and the longer survival of females in all stages of adenocarcinoma likely contributed strongly to this overall trend. Females had longer survival than males overall within squamous cell carcinoma and the pathologically not otherwise specified groups, but this was not uniform across different stages of diagnosis in either group. These results suggest that non-small cell lung cancer survival differences by sex within Canada are similar to those that have been seen in other Western countries. Lastly, further research is required to determine the value of considering sex as an independent prognostic factor in patients with non-small cell lung cancer in Canada. Thank you for watching this presentation, and I would like to acknowledge everybody on this slide for their contributions to this project.

Chelsea Furtzahadzada

sex

non-small-cell lung cancer

survival

Canada