Non-small-cell lung cancer (NSCLC) is predominantly a disease of the elderly. Retrospective analyses of the National Cancer Institute of Canada Clinical Trials Group JBR.10 trial and the Lung Adjuvant Cisplatin Evaluation (LACE) meta-analysis suggest that the elderly benefit from adjuvant chemotherapy. However, the elderly were under-represented in these studies, raising concerns regarding the reproducibility of the study results in clinical practice.
By using the Ontario Cancer Registry, we identified 6,304 patients with NSCLC who were treated with surgical resection from 2001 to 2006. Registry data were linked to electronic treatment records. Uptake of chemotherapy was compared across age groups: younger than 70, 70 to 74, 75 to 79, and = 80 years. As a proxy of survival benefit from chemotherapy, we compared survival of patients diagnosed from 2004 to 2006 with survival of those diagnosed from 2001 to 2003. Hospitalization rates within 6 to 24 weeks of surgery served as a proxy of severe chemotherapy-related toxicity.
In all, 2,763 (43.8%) of 6,304 surgical patients were elderly (age = 70 years). Uptake of adjuvant chemotherapy in the elderly increased from 3.3% (2001 to 2003) to 16.2% (2004 to 2006). Among evaluable elderly patients, 70% received cisplatin and 28% received carboplatin-based regimens. Requirements for dose adjustments or drug substitutions were similar across age groups. Hospitalization rates within 6 to 24 weeks of surgery were similar across age groups (28.0% for patients age
The Alaska Area Health Education Centers (AHEC) program began at the University of Alaska Anchorage (UAA) in 2005. AHECs are academic and community-based partnerships engaged in primary care workforce engagement, training and recruiting, and retaining activities to improve the distribution, diversity, supply and quality of health care personnel. The Alaska AHEC program office (at UAA) contracts with five regional Centers to implement educational activities involving health professions and to expose students to primary care delivery in rural and/or underserved settings. In addition, AHECs work closely with state and local workforce investment boards to identify and address health care needs and shortages.
The Alaska Center for Rural Health (ACRH) was created in 1987 by rural health care providers, educators, and administrators. Our mission is to help strengthen systems to deliver comprehensive and culturally relevant health care to rural Alaskans.
AEHA is a professional group of sanitarians and environmental health professionals who work to control those factors of the environment that result or may result in harmful effects to the health and well-being of all Alaskans.
The Alaska Forum, Inc., was initially formed as an organization to support an annual educational event, the Alaska Forum on the Environment. This widely recognized event began in 1990 as the Alaska Federal Facility Environmental Roundtable as an annual conference focused on contaminants, hazardous waste cleanup, hazardous materials management, pollution prevention, etc. at federal facilities.