Association of Food Desert Residence and 5-Year Mortality in Lung Cancer Patients Undergoing Resection

Area of Science:

• Oncology
• Public Health
• Socioeconomic Determinants of Health

Background:

• Food desert (FD) residence is a known risk factor for adverse outcomes in several cancer types, including breast, colon, and esophageal cancers.
• The impact of food deserts on non-small cell lung cancer (NSCLC) patient outcomes, particularly those treated with anatomic lung resection (ALR), requires further investigation.

Purpose of the Study:

• To investigate the association between food desert residence and mortality risk in patients with non-small cell lung cancer (NSCLC) who underwent anatomic lung resection (ALR).

Main Methods:

• A retrospective review of all consecutive ALRs for stage I-III NSCLC between January 2015 and December 2017.
• Food desert (FD) residence was defined by the United States Department of Agriculture criteria.
• Cox proportional hazard analysis was employed to model 5-year overall mortality, 30-day complications, and 1- and 3-year mortality, adjusting for relevant covariates.

Main Results:

• Out of 348 ALRs, 101 patients (29%) resided in a food desert.
• Unadjusted analysis indicated a lower 5-year mortality risk for patients in food deserts (HR=0.56, P=0.04).
• This association was not statistically significant after adjusting for covariates (HR=0.59, P=0.07).

Conclusions:

• Food desert residence was not significantly associated with increased 5-year mortality risk in NSCLC patients undergoing ALR.
• Potential selection bias, where only healthier patients are deemed fit for surgery, might explain the lack of association, differing from findings in other cancers.
• Further research encompassing all NSCLC patients, irrespective of treatment modality, is warranted to fully assess the role of food deserts as a risk factor.