Cancer Res Treat.  2018 Jul;50(3):757-767. 10.4143/crt.2017.050.

Trend Analysis for the Choice and Cost of Lung Cancer Treatment in South Korea, 2003-2013

• Kim D
• Kim SY
• Suh B
• Park JH

• KMID: 2417865
• DOI: http://doi.org/10.4143/crt.2017.050

Abstract

PURPOSE
Our study aimed to report the annual changes in lung cancer statistics and analyze trends in sociodemographic, medical, and financial factors from 2003 to 2013 in the national database from the Korean National Health Insurance (KNHI).
MATERIALS AND METHODS
Among 7,489 patients with code C34 in KNHI database, only lung cancer patients newly diagnosed after 2003 were included in the study population, for a total of 4,582 patients. Descriptive statistics were used to characterize treatment patterns and medical costs according to sociodemographic factors.
RESULTS
Approximately 70% of subjects were male, and the mean age was 67 years. Around 46% of patients were over 70 years old, and 12% were over 80 years old. The medical costs were highest for patients younger than 60 and lowest for those over 80 years old. Surgery was more common in younger patients, while "no treatment" increased greatly with age. In trend analysis, the proportions of aging (p for trend < 0.001), female (p for trend=0.003), metropolitan/urban (p for trend=0.041), and lowest or highest-income patients (p for trend=0.004) increased over time, along with the prevalence of surgery as the primary treatment (p for trend < 0.001). There was also a trend with regard to change in medical costs (p for trend < 0.001), in that those of surgery and radiotherapy increased.
CONCLUSION
Surgery as a curative treatment has increased over the past decade. However, the elderly, suburban/rural residents, and low-income patients were more likely to be untreated. Therefore, active measures are required for these increasingly vulnerable groups.

Keyword

Lung neoplasms; Practice patterns; Pneumonectomy

MeSH Terms

Aged
Aging
Female
Humans
Korea*
Lung Neoplasms*
Lung*
Male
National Health Programs
Pneumonectomy
Prevalence
Radiotherapy

Figure

• 

  Fig. 1. Disposition of study subjects. NHIS, National Health Interview Survey.

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  Fig. 2. Overview of medical costs and primary treatment regimens by sociodemographic factors of lung cancer patients in Korea, 2003-2013. Overview of the medical costs (in Korean won) of newly diagnosed lung cancer cases from 2003 to 2013 in Korea by sex (A), age group (B), income level (C), and residence (D) are shown. The proportions of the primary treatment regimens by sex (E), age group (F), income level (G), and residence (H) are shown. OP, surgical treatment; RTx, radiation therapy; CTx, chemotherapy; OP+Adjuvant, OP+CTx or OP+RTx or OP+CTx+RTx; Tx, treatment; Q, quartile.

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  Fig. 3. Trends in lung cancer by sociodemographic factors in Korea, 2003-2013. Trends in newly diagnosed lung cancer cases by sociodemographic factors from 2003 to 2013 are shown based on the proportion of cases for each year. Trends by sex (A), age group (B), income levels (C), and residence (D) are shown. Q, quartile.

• 

  Fig. 4. Trends in the primary treatment of lung cancer in Korea, 2003-2013. Trends in the primary treatment of lung cancer in Korea from 2003 to 2013 are shown based on the proportion of newly diagnosed cases for each year. Trends in the primary treatment modality (A), primary treatment regimen (B), and primary surgical treatment (C) are shown. OP, surgical treatment; CTx, chemotherapy; RTx, radiation therapy; OP+Adjuvant, OP+CTx or OP+RTx or OP+CTx+RTx; Tx, treatment; MLND, mediastinal lymph node dissection.

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  Fig. 5. Trends in medical costs for the primary treatment of lung cancer in Korea, 2003-2013. Trends in medical costs for the primary treatment of lung cancer in Korea from 2003 to 2013 are shown based on the mean cost for each primary treatment modality for each year. Trends are shown in terms of the proportion of the mean cost (A), as well as in terms of the absolute value of the mean cost in Korean won (B). OP, surgical treatment; RTx, radiation therapy; CTx, chemotherapy; Tx, treatment. p for trend, OP < 0.0001, RTx < 0.001, CTx=0.023.

Reference

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