Evidence has shown that patients with lung cancer who do not receive guideline-concordant treatment experience worse outcomes. It is crucial that all patients are provided with treatment that meets appropriate clinical guidelines.
Researchers from the University of Michigan examined the level of adherence to minimal lung cancer treatment guidelines recommended by the National Comprehensive Cancer Network in the United States. This research was conducted to determine if disparities existed in adherence to these guidelines among several populations.
The researchers reviewed 441,812 lung cancer cases using data from the National Cancer Database. The data collected spanned four years. The researchers documented which cases received guideline-concordant treatment. Logistic regression models were used to determine disparities based on age and race/ethnicity in all subgroups.
Ultimately, it was found that 62.1% of patients received guideline-concordant treatment, 21.6% received no treatment, and 16.3% received less intensive treatment than the recommended guidelines. The most common less-intensive treatments for localized non-small cell lung cancer were conventionally fractionated radiotherapy and chemotherapy.
Several disparities were evident in cases where care did not meet recommended treatment guidelines. As patient age increased, the likelihood of receiving guideline-concordant treatment decreased. Inadequate treatment for the elderly was present in all subgroups. Non-Hispanic Blacks were also less likely to receive guideline-concordant treatment.
The researchers concluded that a significant disparity in quality healthcare exists for elderly and non-Hispanic Black patients with lung cancer. Their study suggests that these populations are not receiving the recommended care advised by the National Comprehensive Cancer Network.
A call to action is made for oncologists to be aware of common disparities in their adherence to lung cancer treatment guidelines, particularly for the elderly and non-Hispanic Black populations. Guideline-concordant lung cancer treatment must be implemented, especially for these at-risk populations .
Source: Blom, E. F., ten Haaf, K., Arenberg, D. A., & de Koning, H. J. (2020). Disparities in receiving guideline-concordant treatment for lung cancer in the United States. Annals of the American Thoracic Society, 17(2), 186–194. https://doi.org/10.1513/annalsats.201901-094oc