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IntroductionThis study describes the evolving characteristics of patients with small cell lung cancer (SCLC) from 1989 to 2020 in the Netherlands to analyze how the population of patients with SCLC has changed in the last decades, hypothesizing that this might explain the little progress made in SCLC.MethodsPatients with SCLC diagnosed from 1989 to 2020 were selected from the Dutch cancer registry. Incidence, patient and disease characteristics, treatments, and OS were analyzed. Joinpoint analyses were used to test annual percentage changes for statistical significance.ResultsA total of 52,527 patients were diagnosed with SCLC. The absolute numbers of patients with SCLC remained equal over the years, however the incidence rates decreased from 15.01 to 8.93 per 100,000 person-years. The proportion of women increased from 22% to 50%, and those aged ≥75 years increased from 20% to 25%. The latter coincided with a higher proportion receiving only best supportive care over the years (18% to 24%). The use of surgery in stage I increased from 2% to 37%. The proportion of patients diagnosed with stage IV increased from 46% to 70% due to better staging. The OS improved for all stages, with a 2-year OS rate for stage IV doubling from 3% to 6%.ConclusionThe incidence of SCLC has significantly decreased over the last 30 years, with an increasing proportion of elderly and women. The male-female ratio became similar and the OS improved. As a consequence of more elderly and probably more vulnerable patients, more patients received only best supportive care.
Dumoulin et al. (Wed,) studied this question.