Increasing access to medical oncology consultation in older patients with stage II-IIIA non-small-cell lung cancer

Jue Wang, Yong Fang Kuo, Jean Freeman, James Goodwin

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Resectable non-small-cell lung cancer (NSCLC) was once considered a disease whose sole therapy was surgical resection. Therefore it was managed by surgeons. However, with growing evidence of the benefit of adjuvant chemotherapy, such patients should also be evaluated by a medical oncologist. Methods: Using data from the Surveillance, Epidemiology, and End Results (SEER) Program, we identified 3,196 patients 66-85 years of age with stage II or IIIA NSCLC who underwent resection between 1992 and 2002 in the United States. We examined the trend in medical oncology consultation to identify predictors associated with oncology consultation and subsequent use of adjuvant chemotherapy, using modified Poisson regression. Results: From 1992 to 2002, 1,521 patients (47.6%) with resected stage II or IIIA NSCLC were seen by a medical oncologist within 4 months of diagnosis. Strong predictors for medical oncology referral included: being younger, married, having an advanced tumor, adenocarcinoma histology, receiving radiation, and certain SEER geographic regions. The proportion of patients seen by a medical oncologist more than doubled over the ten-year study period, from 28.4% in 1992 to 57.7% in 2002 (P < 0.001). The use of adjuvant chemotherapy rose similarly in this population. Chemotherapy use varied significantly by patient characteristics, including age, marital status, and geographic region. This variation decreased, however, when analysis was restricted to those seen by a medical oncologist within four months of diagnosis. Conclusions: Our results demonstrate that the role of a medical oncologist as part of the multidisciplinary management of resected NSCLC increased over time, greatly reducing variation in NSCLC management.

Original languageEnglish (US)
Pages (from-to)125-132
Number of pages8
JournalMedical Oncology
Volume25
Issue number2
DOIs
StatePublished - Jun 2008

Fingerprint

Medical Oncology
Non-Small Cell Lung Carcinoma
Referral and Consultation
Adjuvant Chemotherapy
SEER Program
Marital Status
Histology
Epidemiology
Adenocarcinoma
Oncologists
Radiation
Drug Therapy
Population
Neoplasms

Keywords

  • Adjuvant chemotherapy
  • Medical oncology consultation
  • Non-small-cell lung cancer (NSCLC)
  • SEER-Medicare database

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Hematology

Cite this

Increasing access to medical oncology consultation in older patients with stage II-IIIA non-small-cell lung cancer. / Wang, Jue; Kuo, Yong Fang; Freeman, Jean; Goodwin, James.

In: Medical Oncology, Vol. 25, No. 2, 06.2008, p. 125-132.

Research output: Contribution to journalArticle

@article{5d88164b768046838772025cddc0ceb2,
title = "Increasing access to medical oncology consultation in older patients with stage II-IIIA non-small-cell lung cancer",
abstract = "Background: Resectable non-small-cell lung cancer (NSCLC) was once considered a disease whose sole therapy was surgical resection. Therefore it was managed by surgeons. However, with growing evidence of the benefit of adjuvant chemotherapy, such patients should also be evaluated by a medical oncologist. Methods: Using data from the Surveillance, Epidemiology, and End Results (SEER) Program, we identified 3,196 patients 66-85 years of age with stage II or IIIA NSCLC who underwent resection between 1992 and 2002 in the United States. We examined the trend in medical oncology consultation to identify predictors associated with oncology consultation and subsequent use of adjuvant chemotherapy, using modified Poisson regression. Results: From 1992 to 2002, 1,521 patients (47.6{\%}) with resected stage II or IIIA NSCLC were seen by a medical oncologist within 4 months of diagnosis. Strong predictors for medical oncology referral included: being younger, married, having an advanced tumor, adenocarcinoma histology, receiving radiation, and certain SEER geographic regions. The proportion of patients seen by a medical oncologist more than doubled over the ten-year study period, from 28.4{\%} in 1992 to 57.7{\%} in 2002 (P < 0.001). The use of adjuvant chemotherapy rose similarly in this population. Chemotherapy use varied significantly by patient characteristics, including age, marital status, and geographic region. This variation decreased, however, when analysis was restricted to those seen by a medical oncologist within four months of diagnosis. Conclusions: Our results demonstrate that the role of a medical oncologist as part of the multidisciplinary management of resected NSCLC increased over time, greatly reducing variation in NSCLC management.",
keywords = "Adjuvant chemotherapy, Medical oncology consultation, Non-small-cell lung cancer (NSCLC), SEER-Medicare database",
author = "Jue Wang and Kuo, {Yong Fang} and Jean Freeman and James Goodwin",
year = "2008",
month = "6",
doi = "10.1007/s12032-007-9003-5",
language = "English (US)",
volume = "25",
pages = "125--132",
journal = "Medical oncology (Northwood, London, England)",
issn = "1357-0560",
publisher = "Humana Press",
number = "2",

}

TY - JOUR

T1 - Increasing access to medical oncology consultation in older patients with stage II-IIIA non-small-cell lung cancer

AU - Wang, Jue

AU - Kuo, Yong Fang

AU - Freeman, Jean

AU - Goodwin, James

PY - 2008/6

Y1 - 2008/6

N2 - Background: Resectable non-small-cell lung cancer (NSCLC) was once considered a disease whose sole therapy was surgical resection. Therefore it was managed by surgeons. However, with growing evidence of the benefit of adjuvant chemotherapy, such patients should also be evaluated by a medical oncologist. Methods: Using data from the Surveillance, Epidemiology, and End Results (SEER) Program, we identified 3,196 patients 66-85 years of age with stage II or IIIA NSCLC who underwent resection between 1992 and 2002 in the United States. We examined the trend in medical oncology consultation to identify predictors associated with oncology consultation and subsequent use of adjuvant chemotherapy, using modified Poisson regression. Results: From 1992 to 2002, 1,521 patients (47.6%) with resected stage II or IIIA NSCLC were seen by a medical oncologist within 4 months of diagnosis. Strong predictors for medical oncology referral included: being younger, married, having an advanced tumor, adenocarcinoma histology, receiving radiation, and certain SEER geographic regions. The proportion of patients seen by a medical oncologist more than doubled over the ten-year study period, from 28.4% in 1992 to 57.7% in 2002 (P < 0.001). The use of adjuvant chemotherapy rose similarly in this population. Chemotherapy use varied significantly by patient characteristics, including age, marital status, and geographic region. This variation decreased, however, when analysis was restricted to those seen by a medical oncologist within four months of diagnosis. Conclusions: Our results demonstrate that the role of a medical oncologist as part of the multidisciplinary management of resected NSCLC increased over time, greatly reducing variation in NSCLC management.

AB - Background: Resectable non-small-cell lung cancer (NSCLC) was once considered a disease whose sole therapy was surgical resection. Therefore it was managed by surgeons. However, with growing evidence of the benefit of adjuvant chemotherapy, such patients should also be evaluated by a medical oncologist. Methods: Using data from the Surveillance, Epidemiology, and End Results (SEER) Program, we identified 3,196 patients 66-85 years of age with stage II or IIIA NSCLC who underwent resection between 1992 and 2002 in the United States. We examined the trend in medical oncology consultation to identify predictors associated with oncology consultation and subsequent use of adjuvant chemotherapy, using modified Poisson regression. Results: From 1992 to 2002, 1,521 patients (47.6%) with resected stage II or IIIA NSCLC were seen by a medical oncologist within 4 months of diagnosis. Strong predictors for medical oncology referral included: being younger, married, having an advanced tumor, adenocarcinoma histology, receiving radiation, and certain SEER geographic regions. The proportion of patients seen by a medical oncologist more than doubled over the ten-year study period, from 28.4% in 1992 to 57.7% in 2002 (P < 0.001). The use of adjuvant chemotherapy rose similarly in this population. Chemotherapy use varied significantly by patient characteristics, including age, marital status, and geographic region. This variation decreased, however, when analysis was restricted to those seen by a medical oncologist within four months of diagnosis. Conclusions: Our results demonstrate that the role of a medical oncologist as part of the multidisciplinary management of resected NSCLC increased over time, greatly reducing variation in NSCLC management.

KW - Adjuvant chemotherapy

KW - Medical oncology consultation

KW - Non-small-cell lung cancer (NSCLC)

KW - SEER-Medicare database

UR - http://www.scopus.com/inward/record.url?scp=48049084809&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=48049084809&partnerID=8YFLogxK

U2 - 10.1007/s12032-007-9003-5

DO - 10.1007/s12032-007-9003-5

M3 - Article

VL - 25

SP - 125

EP - 132

JO - Medical oncology (Northwood, London, England)

JF - Medical oncology (Northwood, London, England)

SN - 1357-0560

IS - 2

ER -