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Increasing Time-to-Treatment for Lung Cancer: Are We Going Backward?

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Delays in lung cancer treatment initiation are increasing. Black patients face significantly longer wait times, highlighting healthcare disparities in cancer care.

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Area of Science:

  • Oncology
  • Health Services Research
  • Health Disparities

Background:

  • Treatment delays in lung cancer care are influenced by patient, provider, and institutional factors.
  • The precise contributions of these factors to delayed lung cancer treatment remain unclear.

Purpose of the Study:

  • To investigate specific predictors of increased time-to-treatment initiation for lung cancer.
  • Utilize the National Cancer Database to analyze factors influencing treatment delays.

Main Methods:

  • Analysis of 567,783 patients with stage I-IV non-small cell lung cancer (2010-2018).
  • Time-to-treatment initiation defined as days from radiologic diagnosis to first treatment.
  • Mixed-effects negative binomial regression used to identify predictors of treatment initiation time.

Main Results:

  • Overall mean time-to-treatment initiation increased from 33 days (2010) to 39 days (2018).
  • Black race, later diagnosis year, non-private insurance, and disparate diagnosis/treatment facilities independently predicted longer initiation times.
  • Black race increased initiation time by 15%-20%; radiation therapy increased it by 33%-69% compared to surgery for early stages.

Conclusions:

  • Lung cancer treatment initiation times show an upward trend.
  • Black patients experience significantly longer treatment initiation times, irrespective of disease stage or modality.
  • Prolonged initiation times exacerbate healthcare disparities, disproportionately impacting underserved communities.