Neighborhood Socioeconomics and Lung Cancer Recurrence and Progression

Area of Science:

• Oncology
• Public Health
• Socioeconomic Determinants of Health

Background:

• Lung cancer recurrence and progression affect approximately 50% of patients in the U.S. post-treatment.
• Existing research on lung cancer recurrence risk has not explored the influence of neighborhood socioeconomic status (nSES).

Purpose of the Study:

• To investigate the association between neighborhood socioeconomic status (nSES) and the risk of lung cancer recurrence and progression.
• To determine if socioeconomic factors at the neighborhood level influence post-treatment outcomes for lung cancer patients.

Main Methods:

• Utilized data from 3439 non-small cell lung cancer patients in the Boston Lung Cancer Study (1992-2012).
• Assessed nSES using patient zip code and census tract data for education and income levels.
• Employed multivariable Cox regression to analyze the relationship between nSES and lung cancer recurrence/progression.

Main Results:

• Observed 496 cases of lung cancer recurrence and progression within the study cohort.
• Patients in neighborhoods with lower educational attainment and income (<$75,000) showed increased hazard ratios for recurrence (2%) and progression (10%).
• A 10% increase in disadvantaged neighborhood population correlated with a 3% increase in recurrence hazard and a 3% increase in progression hazard.

Conclusions:

• Neighborhood socioeconomic status is significantly associated with lung cancer recurrence and progression risk.
• Evidence suggests a potential exposure-response relationship, where greater disadvantage correlates with higher risk.
• Disadvantaged neighborhoods are critical targets for public health interventions to mitigate lung cancer morbidity and mortality.