How does autoimmune disease impact treatment and outcomes among patients with lung cancer? A national SEER-Medicare analysis

Lung Cancer : Journal of the International Association for the Study of Lung Cancer
Saad A KhanDavid E Gerber

Abstract

The advent of cancer immunotherapy has made autoimmune disease in oncology populations clinically important. We analyzed the association of autoimmune disease with treatment and outcomes among lung cancer patients. Using linked Surveillance Epidemiology and End Results (SEER)-Medicare data, we identified lung cancer patients diagnosed between 1992 and 2009 with autoimmune diseases. We recorded number and timing of autoimmune disease diagnoses, lung cancer treatment, and markers of healthcare utilization including emergency department visits, hospitalizations, and outpatient visits. To account for potential lead-time bias, we used a matched case-control analysis wherein living and deceased patients were matched on survival time. We performed unadjusted and multivariable adjusted logistic regressions separately by cancer stage for all-cause and lung cancer-specific mortality. Among 172,285 lung cancer patients, 23,084 (13.4%) had ≥1 autoimmune disease at any time. Overall, 10,927 patients (6.3%) had one autoimmune disease before cancer diagnosis; 9338 (5.4%) had two or more before cancer diagnosis; and 2819 (1.6%) had one or more after cancer diagnosis. Healthcare utilization was higher in the autoimmune disease population. Lung ...Continue Reading

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Citations

Nov 1, 2018·British Journal of Cancer·Shaheen KhanDavid E Gerber
Jan 27, 2019·Medical Sciences : Open Access Journal·Tiffany SetoMinggui Pan
Aug 2, 2018·BMC Medical Informatics and Decision Making·Hansi ZhangJiang Bian
Feb 6, 2019·Nature Reviews. Clinical Oncology·D Ross CamidgeKeith M Kerr
Dec 15, 2020·JAMA Network Open·Saya JacobVictoria Villaflor
Mar 18, 2020·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Jordi RemonGiorgio V Scagliotti
Jul 23, 2019·Seminars in Cancer Biology·Shaheen Khan, David E Gerber

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