SURVIVAL ASSOCIATED WITH COPD AMONG SEER-MEDICARE BENEFICIARIES WITH NSCLC

OBJECTIVES: Lung cancer and chronic obstructive pulmonary disease (COPD) are among leading causes of morbidity and mortality worldwide. We investigated the impact of pre-existing COPD and its subtypes, chronic bronchitis and emphysema, on overall survival among Medicare enrollees diagnosed with non-small cell lung cancer (NSCLC). METHODS: Using SEER-Medicare data, we included patients >= 66 years of age diagnosed with NSCLC at any disease stage between 2006 to 2010 and continuously enrolled in Medicare Parts A and B in the 12 months prior to diagnosis. Pre-existing COPD in patients with NSCLC were identified using ICD-9 codes. Kaplan-Meier method and log-rank tests were used to examine overall survival by COPD status and COPD subtype. Multivariate Cox Proportional Hazards models were fit to assess the risk of death after cancer diagnosis. RESULTS: We identified 66,963 lung cancer patients. Of these, 22,497 (33.60%) had documented COPD before NSCLC diagnosis. For each stage of NSCLC, median survival was shorter in the COPD compared to the Non-COPD group (stage I: 692 days vs 1130 days, p< 0.0001; stage II: 473days vs 627 days, p