Age, comorbidity, treatment decision and prognosis in lung cancer

SIR—Lung cancer is now the leading cause of cancer-related death in most developed countries. Approximately 80–85% of lung cancer subtypes are of non-small cell (NSCLC), two-thirds of which are at advanced stages on diagnosis. Like other solid tumours, lung cancer is predominantly a disease of the elderly and ∼30–50% of all patients are older than 70 years when the disease is diagnosed [1, 2]. Despite the high incidence of lung cancer and its high mortality rate in elderly patients, the likelihood of receiving active treatment appears to decrease with increasing age [3, 4]. The presence of comorbid conditions is regarded as an important factor influencing treatment decisions [5]. In spite of the fact that comorbid conditions are very common in the elderly [6], the prognostic impact of age and comorbidity remains controversial. With these aspects in mind, we performed an observational study to analyse the influence of age and comorbidity on choice of treatment and prognosis in advanced NSCLC.