Major changes in men with non-small-cell lung cancer (NSCLC) in 10 years: The KBP-2000-CPHG and KBP-2010-CPHG cohorts

Background and objectives: Major changes in NSCLC characteristics have been described in female patients in the last decade. The aim of this study is to review the evolution of NSCLC characteristics in male patients. In 2000 and 2010, the French College of General Hospital Respiratory Physicians (CPHG) performed two prospective multicentre studies collecting information on new cases of lung cancer which represented 1 in 5 of lung cancers diagnosed in France. Methods: The two cohorts included all consecutive patients ≥18 years with primary lung cancer diagnosed histologically or cytologically during two years periods from the 1st of January and the 31st of December 2000 and 2010 in chest department of participating centres. A standardised form was completed for each patient and a steering committee checked recruitment exhaustiveness. Findings: 137 centres in 2000 and 104 centres in 2010 included respectively 4,720 and 6,101 NSCLC patients; 3,921 (83.1%) and 4,597 (75.3%) were male. Major increasing changes were found in 2010 compared to 2000: average age (65.7+/-10.9 vs 64.4+/-11.1 years, p<0.0001), rate of non-smokers (4.7% vs 2.5%, p<0.0001), rate of adenocarcinoma (48.7% vs 31.5%, p<0.0001), association with occupational exposure (24.9% vs 11.7%). In 2010, less curative surgery was performed (19.1% vs 23.4%, p<0.0001) and less patients were included in clinical trials (3.3% vs 4.7%, p=0.002). Stage IV at diagnosis remained frequent (56.9% vs 41.6%, p<0.0001). Interpretation: In 10 years, the proportion of men decreased and the characteristics of their NSCLC changed. The consequences of these changes on short and long-term survival need to be studied.