Introduction: Although prior research has demonstrated lower lung cancer survival in England than in the United States, more detailed comparisons are needed. We conducted a population‐based analysis to compare diagnostic, treatment, and survival patterns. Methods: Data from cancer registries and administrative databases were linked for older patients with a diagnosis of NSCLC in England and the United States (2008–2012). We compared patient and clinical characteristics, as well as the distribution of age‐standardized receipt of treatment by stage. We compared relative survival overall by stage and treatment. Finally, we assessed the degree to which stage distribution and stage‐specific survival contributed to survival differences. Results: Among patients age 66 years or older with a diagnosis of NSCLC in England (n = 86,978) and the United States (n = 84,415), the rate of pathological confirmation was 63% in England compared with 85% in the United States (a 22.2% difference [99% confidence interval: 22.8%–21.7%]). The rate of receipt of active treatment was lower in England than in the United States (46% versus 60%, for a difference of 14.0% [99% confidence interval: 13.3%–14.7%]). In England, we identified 98 excess deaths per 1000 patients with pathologically confirmed NSCLC; these additional deaths could be partially mitigated by adjusting stage at diagnosis (reduction to 54 excess deaths) or stage‐specific survival (reduction to 36 excess deaths). Conclusions: Compared with patients with NSCLC in the United States, patients with NSCLC in England are less likely to present with early‐stage disease and receive treatment and are more likely to die. Future work should explore whether the intensity of resources directed to diagnostic and therapeutic activity may help mitigate disparities in outcomes.

中文翻译：

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2008-2012年英国和美国老年肺癌患者的护理和预后

简介：尽管先前的研究表明英格兰的肺癌存活率低于美国，但仍需要进行更详细的比较。我们进行了一项基于人群的分析，以比较诊断、治疗和生存模式。方法：将来自癌症登记处和行政数据库的数据与英国和美国（2008-2012 年）诊断为 NSCLC 的老年患者相关联。我们比较了患者和临床特征，以及按阶段接受治疗的年龄标准化分布。我们比较了分期和治疗的总体相对生存率。最后，我们评估了分期分布和分期生存对生存差异的影响程度。结果：在英格兰 66 岁或以上诊断为 NSCLC 的患者中（n = 86，978) 和美国 (n = 84,415)，英国的病理确诊率为 63%，而美国为 85%（差异为 22.2% [99% 置信区间：22.8%–21.7%]）。英格兰接受积极治疗的比率低于美国（46% 对 60%，差异为 14.0% [99% 置信区间：13.3%–14.7%]）。在英格兰，我们发现每 1000 名经病理证实的 NSCLC 患者中有 98 例超额死亡；通过调整诊断阶段（减少到 54 例额外死亡）或特定阶段生存（减少到 36 例额外死亡），可以部分减轻这些额外的死亡。结论：与美国的非小细胞肺癌患者相比，英格兰的非小细胞肺癌患者出现早期疾病和接受治疗的可能性更小，更容易死亡。