Epidemiology of metastatic lung cancer in France between 2013 and 2021: Observational study using the French claims database

Introduction > Treatment landscape in metastatic lung cancer has progressed quickly over the last decade, mainly due to immunotherapies and targeted therapies. This study aimed to describe change in epidemiological data of patients with metastatic lung cancer. Methods > A cohort of patients identified between 2013 and 2021 with lung cancer and a marker of metastases (ICD-10 code or reimbursement for Bevacizumab or Pemetrexed) was built from the French claims database. A trend analysis of the rate of newly-diagnosed metastatic patients and the proportion of deaths over the study period was performed using Joinpoint (R) software. Results > Between 2013 and 2021, 147,760 metastatic lung cancer patients were identified (men: 66.5%, median age: 66 years). A statistically significant decrease in the crude rate of newly- diagnosed metastatic patients was observed in men (-1.18% per year in average), whereas a statistically significant increase was described in women (+2.36% per year in average). A downward trend in the proportion of deaths was found for both gender (-4.37% and-5.07% per year on average, respectively). Discussion > This study provides unpublished epidemiological data on metastatic lung cancer in France and confirms sex-differentiated trends in the rate of newly-diagnosed metastatic patients, already observed for all stages combined. A statistically significant decrease in the proportion of deaths among metastatic lung cancer patients is observed in both genders. These results underline the importance of ongoing investments in prevention and screening initiatives to reverse the incidence trends observed in women. Moreover, it highlights the criticality of therapeutic innovation in sustaining the increase in survival.