Anti-estrogen Use, Estrogen Receptor Expression, Smoking Patterns, and Survival of Women with Non-Small-Cell Lung Cancer: A Manitoba Perspective
Loading...
Date
2012-03-12
Authors
Lother, Sylvain
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Lung cancer is the leading cause of cancer death worldwide. Gender
differences in lung cancer outcomes are known. When compared to men, women have
significantly better survival and women are more likely to develop lung cancer when nonsmokers.
Research suggests estrogen plays a key role in the risk of development and
outcomes of lung cancer. Accordingly, anti-estrogen use should also influence survival in
female non-small cell lung cancer (NSCLC) patients. In this study we compared mortality
among anti-estrogen users and non-users. METHODS: This population-based study had
a retrospective study design. Using the Manitoba Cancer Registry (MCR) we identified
all women diagnosed with NSCLC from 2000-2007. The Drug Program Information
Network (DPIN) was accessed to establish patients that received anti-estrogens.
Demographic data (e.g. smoking patterns, stage, histology) was gathered by chart review.
Mortality rates for anti-estrogen users and non-users were compared using Kaplan-Meier
survival functions and Cox regression models. RESULTS: 2320 women fit our patient
criteria, of which 156 had received prior anti-estrogens. A positive smoking history was
documented in 88%, 62% being former vs. 26% current smokers. A history of 30+ packyears
was seen in 55%. Exposure to anti-estrogen was associated with a significantly
decreased mortality (HR 0.718, p = 0.0031). Overall survival with anti-estrogen vs. none
resulted in median survival of 1.89 vs. 0.93 years, respectively (p < 0.0001).
CONCLUSIONS: Our results demonstrate that anti-estrogens are associated with
decreased mortality from NSCLC. These findings supplement and reinforce past evidence
that estrogen plays a key factor in the biology and outcomes of NSCLC.
Description
Keywords
medicine