Management and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system.

<h4>Hypothesis</h4>There is limited data on the care and outcomes of individuals with both chronic obstructive pulmonary disease (COPD) and lung cancer, particularly in advanced disease. We hypothesized such patients would receive less cancer treatment and have worse outcomes.<h4>M...

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Autores principales:	John R Goffin, Sophie Corriveau, Grace H Tang, Gregory R Pond
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8bc7c8b810854dcf9c8a2fcc6c268c08
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spelling	oai:doaj.org-article:8bc7c8b810854dcf9c8a2fcc6c268c082021-11-25T06:19:11ZManagement and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system.1932-620310.1371/journal.pone.0251886https://doaj.org/article/8bc7c8b810854dcf9c8a2fcc6c268c082021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251886https://doaj.org/toc/1932-6203<h4>Hypothesis</h4>There is limited data on the care and outcomes of individuals with both chronic obstructive pulmonary disease (COPD) and lung cancer, particularly in advanced disease. We hypothesized such patients would receive less cancer treatment and have worse outcomes.<h4>Methods</h4>We analyzed administrative data from the province of Ontario including demographics, hospitalization records, physician billings, cancer diagnosis, and treatments. COPD was defined using the ICES-derived COPD cohort (1996-2014) with data from 2002 to 2014. Descriptive statistics and multivariable analyses were undertaken.<h4>Results</h4>Of 105 304 individuals with lung cancer, 43 375 (41%) had stage data and 36 738 (34.9%) had COPD. Those with COPD were likely to be younger, have a Charlson score ≤ 1, have lower income, to live rurally, and to have stage I/II lung cancer (29.8 vs 26.5%; all p<0.001). For the COPD population with stage I/II cancer, surgery and adjuvant chemotherapy were less likely (56.8 vs. 65.9% and 15.4 vs. 17.1%, respectively), while radiation was more likely (26.0 vs. 21.8%) (p all < 0.001). In the stage III/IV population, individuals with COPD received less chemotherapy (55.9 vs 64.4%) or radiation (42.5 vs 47.5%; all p<0.001). Inhaler and oxygen use was higher those with COPD, as were hospitalizations for respiratory infections and COPD exacerbations. On multivariable analysis, overall survival was worse among those with COPD (HR 1.20, 95% CI 1.19-1.22).<h4>Conclusions</h4>A co-diagnosis of COPD and lung cancer is associated with less curative treatment in early stage disease, less palliative treatment in late stage disease, and poorer outcomes.John R GoffinSophie CorriveauGrace H TangGregory R PondPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251886 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q John R Goffin Sophie Corriveau Grace H Tang Gregory R Pond Management and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system.
description	<h4>Hypothesis</h4>There is limited data on the care and outcomes of individuals with both chronic obstructive pulmonary disease (COPD) and lung cancer, particularly in advanced disease. We hypothesized such patients would receive less cancer treatment and have worse outcomes.<h4>Methods</h4>We analyzed administrative data from the province of Ontario including demographics, hospitalization records, physician billings, cancer diagnosis, and treatments. COPD was defined using the ICES-derived COPD cohort (1996-2014) with data from 2002 to 2014. Descriptive statistics and multivariable analyses were undertaken.<h4>Results</h4>Of 105 304 individuals with lung cancer, 43 375 (41%) had stage data and 36 738 (34.9%) had COPD. Those with COPD were likely to be younger, have a Charlson score ≤ 1, have lower income, to live rurally, and to have stage I/II lung cancer (29.8 vs 26.5%; all p<0.001). For the COPD population with stage I/II cancer, surgery and adjuvant chemotherapy were less likely (56.8 vs. 65.9% and 15.4 vs. 17.1%, respectively), while radiation was more likely (26.0 vs. 21.8%) (p all < 0.001). In the stage III/IV population, individuals with COPD received less chemotherapy (55.9 vs 64.4%) or radiation (42.5 vs 47.5%; all p<0.001). Inhaler and oxygen use was higher those with COPD, as were hospitalizations for respiratory infections and COPD exacerbations. On multivariable analysis, overall survival was worse among those with COPD (HR 1.20, 95% CI 1.19-1.22).<h4>Conclusions</h4>A co-diagnosis of COPD and lung cancer is associated with less curative treatment in early stage disease, less palliative treatment in late stage disease, and poorer outcomes.
format	article
author	John R Goffin Sophie Corriveau Grace H Tang Gregory R Pond
author_facet	John R Goffin Sophie Corriveau Grace H Tang Gregory R Pond
author_sort	John R Goffin
title	Management and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system.
title_short	Management and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system.
title_full	Management and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system.
title_fullStr	Management and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system.
title_full_unstemmed	Management and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system.
title_sort	management and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/8bc7c8b810854dcf9c8a2fcc6c268c08
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Management and outcomes of patients with chronic obstructive lung disease and lung cancer in a public healthcare system.

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