A total of 94,7463 patients with lung cancer were identifi ed between 1973 and 2010 ( Tables 1 , 2 ). Th e proportion of SCLC to total lung cancers decreased over the years along with the sex gap; the ratio of men to women decreased from 2.69:1 in 1973 to 1:1 in 2010. Th e fi ndings were consistent between both black and white patients. Th e incidence of SCLC compared with all lung cancer was consistently higher in whites compared with the black population. Th ere were no diff erences in the stage at presentation between blacks and whites (24.17% vs 23.1% pre sented in limited stage and 53.68% vs 52.55% presented in extensive stage, respectively; P 5 .343). Women presented with limited-stage disease more oft en than men (26.28% vs 20.75%, respectively; P Յ .0001); this diff erence was consistent in white (26.22% vs 20.4%, P , .0001) as well as black subgroups (26.79% vs 22.15%, P 5 .0184). Blacks pre sented at a younger age compared with whites. Some 48.45% of blacks presented with SCLC before the age of 65 years compared with 39.49% of whites. Th ere were no diff erences in the age of presentation between sexes in either blacks or whites. Although there were no diff erences in mortality between races, survival analysis showed that women had a better cancer-specifi c survival than men (Kaplan-Meier curves) ( Fig 1 ). Th is fi nding was consistent in both whites and blacks ( P Յ .0001).Our analysis of the SEER database for the years 1973 to 2010 suggests that the incidence of SCLC has been decreasing over the years in both black and white populations, but the incidence of SCLC in women is increasing compared with men. We speculate that these results could be due to changes in smoking habits over time. Th e percentage of smokers has decreased over the years, 1 but the prevalence of female smokers has been increasing. 2 Th ere were no signifi cant diff erences in mortality between races, but when comparing sex, women have a better survival, which could be explained partially by being presented at an earlier stage compared with men. 3 Other studies have shown that female sex is a favorable prognostic factor independent of age, performance status, stage, and presence of metastases. 4 , 5 SCLC remains a disease with poor prognosis and high mortality. Further studies on epidemiology of SCLC may help understand pathogenesis and eventually lead to improved survival.

No abstract

A database was constructed that facilitated the development of multiple interfaces for varying professionals. Content management is streamlined from a centralized location, also ensuring consistency of guidelines between medical practitioners and case managers and claims adjustors. DISCUSSION (CONCLUSION): This study demonstrates that delivery of treatment guideline recommendations in a decision support system is an effective dissemination strategy that can be tailored to the needs of users not necessarily trained in the interpretation and use of medical evidence. Combining this with an interface for physicians provides a mechanism that can improve the alignment between physician clinical decision-making and that of insurance professionals. TARGET AUDIENCE(S): 1. Guideline developer 2. Guideline implementer 3. Developer of guideline-based products 4. Health care policy analyst/policy-maker 5. Health insurance payers and purchasers

No abstract

No abstract