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In the United States, thousands of patients are treated for non-small cell lung cancer (NSCLC) each year. For localized NSCLC, there is a 63% 5-year survival rate. There is a 35% 5-year survival rate for regional NSCLC. With the improvements made in lung cancer treatment, including new targeted treatments and immunotherapies, patients with NSCLC are living longer than ever before. 

Health equity is crucial so that all patients reap the benefits of these treatment advances. There is evidence of unjust differences in NSCLC treatment in specific populations. Researchers from Beth Israel Deaconess Medical Center in Boston, Massachusetts examined treatment disparities that exist for Medicare patients with disabilities and stage I NSCLC.

This retrospective analysis compared stage I non-small cell lung cancer treatment and survival rate data for Medicare patients with and without disabilities. The participants included 8,425 individuals without disabilities and 1,016 individuals with disabilities. They were diagnosed with stage I non-small cell lung cancer between the ages of 21 and 64. Medicare patients with disabilities were most likely to be non-Hispanic Black males.

Ultimately, it was found that 82.2% of participants without disabilities and 68.5% of participants with disabilities received surgical treatment for NSCLC. The risk of being denied surgery was especially high in participants with respiratory disabilities, nervous system disorders, mental health conditions, and mental retardation. 

Moreover, the participants with disabilities had a significantly higher risk of cancer-specific mortality than the participants without disabilities. However, this risk became insignificant once adjusted for treatment differences. 

The researchers concluded that a disparity in the treatment of NSCLC exists for Medicare patients with disabilities. Study participants with disabilities were shown to receive surgical treatment less often, resulting in significantly higher cancer-specific mortality rates. A call to action is made for oncologists to provide patients with disabilities with equitable NSCLC treatment [1].

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[1] Iezzoni, L. I., Ngo, L. H., Li, D., Roetzheim, R. G., Drews, R. E., & McCarthy, E. P. (2008). Treatment disparities for disabled medicare beneficiaries with stage I non-small cell lung cancer. Archives of Physical Medicine and Rehabilitation, 89(4), 595–601. https://doi.org/10.1016/j.apmr.2007.09.042