The Impact of Residential Racial Segregation on Non-Small Cell Lung Cancer Treatment and Outcomes

Area of Science:

• Oncology
• Public Health
• Sociology

Background:

• Racial disparities in lung cancer diagnosis and treatment persist despite overall incidence decreases.
• Structural racism and residential segregation negatively impact healthcare access and socioeconomic status for Black individuals.
• Understanding the link between residential segregation and non-small cell lung cancer (NSCLC) disparities is crucial.

Purpose of the Study:

• To determine the impact of residential segregation on racial disparities in NSCLC treatment and mortality.
• To analyze how the index of dissimilarity (IoD) affects diagnosis stage and surgical resection rates.
• To assess cancer-specific survival differences between racial groups based on IoD.

Main Methods:

• Utilized Surveillance, Epidemiology, and End Results (SEER) data for Black and White patients diagnosed with NSCLC (2004-2016).
• Employed regression models to evaluate the association between IoD and diagnosis stage and surgical resection.
• Used competing risk regressions to compare cancer-specific mortality in relation to IoD quartiles.

Main Results:

• Black patients were more likely to be diagnosed at advanced stages and less likely to receive surgical resection as IoD increased.
• These racial disparities in NSCLC treatment were eliminated at low levels of residential segregation.
• Black patients residing in highly segregated areas experienced significantly lower cancer-specific survival.

Conclusions:

• Higher residential segregation is associated with advanced disease presentation, reduced surgical treatment, and increased cancer-specific mortality for Black patients with NSCLC.
• Findings underscore the profound impact of structural racism and residential segregation on NSCLC outcomes.
• Policy reforms addressing residential segregation and its socioeconomic consequences are essential to mitigate these disparities.