TY - JOUR
T1 - Dysphagia prevalence and associated survival differences in older patients with lung cancer
T2 - A SEER-Medicare population-based study
AU - Marmor, Schelomo
AU - Cohen, Seth
AU - Fujioka, Naomi
AU - Cho, L. Chinsoo
AU - Bhargava, Amit
AU - Misono, Stephanie
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/9
Y1 - 2020/9
N2 - Introduction: The impact of dysphagia in persons with lung cancer is unknown. The objective of this study is to measure the prevalence and survival differences associated with dysphagia in older adults with lung cancer. Materials and Methods: Linked SEER cancer registries - Medicare data, 1991–2009 was utilized to identify 201,674 persons with lung cancer. Most were male (53%), had regional or distant disease (74%), and were aged <80 years (82%). The pre-existing prevalence of dysphagia was identified using claims codes before the lung cancer diagnosis. Survival was analyzed using Kaplan Meier curves and Cox proportional hazard models. Results: 8517 (4%) had dysphagia prior to their lung cancer diagnoses. Younger age, worse disease stage, more comorbidities, and hospital rurality were associated with higher likelihood of dysphagia. Patients with dysphagia had worse survival (median survival 8 months [95%CI 7,9]) than those without dysphagia (median survival 12 months [95%CI 11,13]). After adjusting for sociodemographic, clinical, and disease characteristics, dysphagia was still associated with worse survival (Hazard ratio of death 1.34, [95%CI 1.28–1.35], p ≤ .0001). Discussion and Conclusions: This is the first Medicare claims-based study of older adults with lung cancer and dysphagia. Pre-existing dysphagia occurred in approximately 1 in 25 patients with lung cancer and was associated with worse survival. Determining the best methods to evaluate and treat dysphagia in patients with lung cancer is an important avenue for future studies.
AB - Introduction: The impact of dysphagia in persons with lung cancer is unknown. The objective of this study is to measure the prevalence and survival differences associated with dysphagia in older adults with lung cancer. Materials and Methods: Linked SEER cancer registries - Medicare data, 1991–2009 was utilized to identify 201,674 persons with lung cancer. Most were male (53%), had regional or distant disease (74%), and were aged <80 years (82%). The pre-existing prevalence of dysphagia was identified using claims codes before the lung cancer diagnosis. Survival was analyzed using Kaplan Meier curves and Cox proportional hazard models. Results: 8517 (4%) had dysphagia prior to their lung cancer diagnoses. Younger age, worse disease stage, more comorbidities, and hospital rurality were associated with higher likelihood of dysphagia. Patients with dysphagia had worse survival (median survival 8 months [95%CI 7,9]) than those without dysphagia (median survival 12 months [95%CI 11,13]). After adjusting for sociodemographic, clinical, and disease characteristics, dysphagia was still associated with worse survival (Hazard ratio of death 1.34, [95%CI 1.28–1.35], p ≤ .0001). Discussion and Conclusions: This is the first Medicare claims-based study of older adults with lung cancer and dysphagia. Pre-existing dysphagia occurred in approximately 1 in 25 patients with lung cancer and was associated with worse survival. Determining the best methods to evaluate and treat dysphagia in patients with lung cancer is an important avenue for future studies.
KW - Dysphagia
KW - Lung cancer
KW - Survival
KW - Swallowing
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U2 - 10.1016/j.jgo.2020.02.015
DO - 10.1016/j.jgo.2020.02.015
M3 - Article
C2 - 32169546
AN - SCOPUS:85081225675
SN - 1879-4068
VL - 11
SP - 1115
EP - 1117
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
IS - 7
ER -