Racial disparities continue to exist in the treatment and outcomes of patients diagnosed with stage I non-small cell lung cancer, according to research presented at the 2017 Multidisciplinary Thoracic Cancers Symposium in San Francisco.
A team led by Dr. Andrew Farach of Houston Methodist Hospital examined data from the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database for patients ages 60 and older who had been diagnosed with stage I non-small cell lung cancer between 2004 and 2012.
The researchers grouped 62,312 patients into five cohorts: Caucasians (86.6%), African-Americans (8%), Asian/Pacific Islanders (5%), American Indians (0.3%), and patients with unknown racial classification (0.02%). They then compared treatment and survival outcomes among the groups.
Patients received one of four types of primary treatment: surgery only (67%), radiation only (19%), both surgery and radiation (3%), or no treatment/observation only (12%). Farach and colleagues found that the type of treatment patients received varied by race: While 67% of Caucasian patients and 72% of Asian/Pacific Islander patients had surgery, these rates were 56% for African-American patients and 58% for American Indian patients. Patients who underwent surgery or radiation had higher survival rates, the group wrote.
At a median follow-up of 23 months after treatment, overall survival rates were highest for Asian/Pacific Islanders (76%) and Caucasians (70%) and lowest for African-Americans (65%) and American Indians (60%). Lung cancer-specific survival rates were highest for Asian/Pacific Islanders (84%), followed by Caucasians (79%), African-Americans (76%), and American Indians (73%).
"Unfortunately, our findings are not particularly surprising," Farach said in a statement released by the American Society for Radiation Oncology (ASTRO), one of the meeting's sponsors. "Multiple studies have documented racial disparities in the management and outcome of different cancers. As physicians, it becomes our responsibility to understand and address these inequalities."
