Influenza and mortality for non-small cell lung cancer.

Abstract

e13114 Background: Lung cancer is the leading cause of cancer deaths in the United States and worldwide. While influenza illness is known to be particularly dangerous for frail and elderly patients, the relationship between influenza illness and outcomes in cancer patients remains largely unknown. Methods: Monthly mortality rates for all patients at risk, as well as newly diagnosed patients, with non-small cell lung cancer (NSCLC) diagnosed between 2009 and 2015 were compared during high and low flu months using data from the Surveillance, Epidemiology, and End Results (SEER) Program and the Center for Disease Control and Prevention (CDC) website. Influenza severity was determined by the percentage of outpatient visits to healthcare providers for influenza-like illness (ILI). CDC ILI activity levels were matched with SEER data by month and state. State-months with an ILI activity level of 8 or higher were considered to be high flu months, as defined by the CDC. Results: 195,038 patients with NSCLC from 13 states were included in the analysis. 52 out of 1,081 state-months (5.1%) had high flu activity. Monthly mortality rates for low and high flu months were 4.9 and 5.7%, respectively (p = .001). The monthly mortality rate for newly diagnosed patients was also significantly higher during high flu months (9.4 vs. 10.2%, p = .01). When the analysis was limited to winter months only, monthly mortality rates for low and high flu months were 4.7 and 5.3%, respectively (p = .02). The relationship between flu severity and mortality was also observed at the individual state level. Conclusions: Increased influenza severity is associated with higher mortality rates for NSCLC patients. Future research should elucidate the relationship between vaccination and survival in lung cancer patients.