Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Examining Prognostic Disparities between Regional and Metropolitan Lung Cancer Patients: A Registry based study (#330)

Evangeline Samuel 1 2 , Eldho Paul 3 , Sanuki Tissera 1 , Mike Lloyd 1 , Craig Underhill 4 , Sagun Parakh 5 , Rob Blum 6 , Phillip Parente 7 , Inger Oleson 8 , Javier Torres 9 , David Langton 10 , Thomas John 11 , Phillip Antippa 12 , Matthew conron 13 , James Bartlett 14 , Gavin Wright 13 , Wasek Faisal 15 , Nik Zeps 1 , John Zalcberg 16 , Rob Stirling 17 18
  1. School of Public Health and Preventive Medicine , Monash University , Melbourne, Australia
  2. Medical Oncology , Latrobe Regional Health , Victoria , Australia
  3. Monash University , Melbourne, Australia
  4. Albury Wodonga Health , Wondonga, NSW, Australia
  5. Olivia Newton John Cancer Centre , Heidelberg, Victoria, Australia
  6. Bendigo Health , Bendigo , Victoria, Australia
  7. Eastern Health , Melbourne, Victoria , Australia
  8. Barwon Health, Andrew Love Cancer Centre , Geelong , VIC, Australia
  9. Goulburn Valley Health , Shepparton , VIC, Australia
  10. Peninsula Health , Melbourne, VIC, Australia
  11. Department of Oncology , Sir Peter MacCallum , Melbourne, VIC, Australia
  12. Department of Cardiothoracic surgery , The Royal Melbourne Hospital , Melbourne, Vic, Australia
  13. St Vincent's Hospital , Melbourne, VIC, Australia
  14. Western Health , Melbourne, VIC, Australia
  15. Medical Oncology , Grampians Health , Ballarat , VIC, Australia
  16. Medical Oncology , Alfred Hospital , Melbourne, VIC, Australia
  17. Respiratory Medicine , Alfred Hospital , Melbourne, VIC, Australia
  18. Central Clinical School , Department of Medicine, Nursing and Health sciences , Melbourne, VIC, Australia

 

Aims

Lung cancer is the 5th most common cancer in Australia and the leading cause of cancer-related death. This study examines whether prognostic factors and survival rates differ between regional and metropolitan lung cancer patients using a population-based registry cohort.

 

Methods 

Patients with non-small cell lung cancer (NSCLC) diagnosed between 2011 and 2023 were identified from the Victorian Lung Cancer Registry (VLCR). Residence at diagnosis was categorized using the Modified Monash Model (MMM) into metropolitan, regional, remote, and rural. Demographic and cancer-specific characteristics were compared between regional and metropolitan areas. The association between residence at diagnosis and overall survival was assessed using Cox proportional hazards regression models.

 

Results

Of 13,154 NSCLC patients, 4,092 (31%) lived in regional and remote areas. Median age was 68-69 years across groups. Regional/remote patients had more current smokers (36% vs 30%, p<0.001) and fewer never smokers (7% vs 15%, p<0.001) compared to metropolitan patients. No significant differences were observed in gender or comorbidities. Metropolitan patients had fewer cases of stage I and II disease (15% vs 19%, p<0.001). All four SEIFA (Socio-Economic indexes for areas) indices (IRSAD, IRSD, IEO, IER) revealed significantly worse socio-economic conditions in regional and rural communities compared to metropolitan areas (e.g., IRSAD: Metro 8.0 vs Regional 5.0 vs Rural/Remote 3.0, p<0.001). Multivariate analysis showed no significant association between residence at diagnosis and overall survival after adjusting for age, gender, stage, performance status, smoking, and comorbidities (Metropolitan vs Regional HR 0.92, 95% CI 0.85-1.01, p=0.075; Metropolitan vs Rural/Remote HR 0.97, 95% CI 0.92-1.02, p=0.245).