Racial Disparities in Cancer Guideline-Concordant Treatment Using Surveillance, Epidemiology, and End Results Data...

Area of Science:

• Oncology
• Health Services Research
• Health Disparities

Background:

• Racial and ethnic disparities in lung cancer survival remain a significant issue in the U.S.
• Non-Hispanic Black patients face higher lung cancer mortality compared to non-Hispanic White patients.
• Previous studies often examined single treatments, not the full spectrum of care.

Purpose of the Study:

• To assess racial disparities in lung cancer survival and the receipt of comprehensive treatment.
• To develop and utilize a guideline-concordant initial treatment (GCIT) indicator.
• To analyze treatment and survival differences across racial/ethnic groups.

Main Methods:

• Utilized Surveillance, Epidemiology, and End Results data for 377,370 non-small cell lung cancer (NSCLC) patients.
• Developed a GCIT indicator based on National Comprehensive Cancer Network guidelines and disease stage.
• Employed logistic regression and Kaplan-Meier methods to evaluate racial disparities in treatment and survival.

Main Results:

• Non-Hispanic Black patients had lower odds of receiving GCIT (OR=0.80) and surviving 2 years (OR=0.80).
• Non-Hispanic Asian patients had the highest odds of receiving GCIT (OR=1.02).
• GCIT receipt significantly improved survival across all stages and races, with median survival ranging from 67-102 months (GCIT) vs. 11-17 months (no GCIT).

Conclusions:

• Guideline-concordant initial treatment (GCIT) substantially improves lung cancer survival for all racial groups.
• Significant disparities exist in the receipt of GCIT among different racial/ethnic populations.
• Targeted interventions are necessary to promote equitable access to guideline-concordant care and reduce lung cancer survival gaps.