Lung cancer has the highest mortality rate of all cancers. To improve patient survival rates, it is imperative that lung cancer is diagnosed early and that the most effective treatments are available and performed in a timely manner for all populations.
Previous research has identified racial and sex-related disparities in the treatment of patients with non-small cell lung cancer (NSCLC). Researchers with the RAND Corporation in Santa Monica, California sought to determine how patient race and sex correlate with appropriate and timely treatment across the four stages of NSCLC.
This study was conducted using data from four years of Medicare claims. The analysis consisted of 22,145 participants. Race and sex were analyzed to see how they correlated with how often participants received timely and appropriate cancer treatment. Adjustments were made to control for other demographic characteristics, including socioeconomic status, as well as patient comorbidities and provider supply.
Ultimately, it was found that 37.2% of patients with stage I and stage II NSCLC received timely and appropriate treatment. Patients with later stages of the disease received timely treatment 58.1% of the time for stage III NSCLC and 29.2% of the time for stage IV NSCLC.
Further analysis revealed that multiple racial and sex-related disparities were present. For patients with stage I and stage II NSCLC, women were 25% less likely than men to receive timely and appropriate surgery.
Moreover, Black patients with stage I and stage II NSCLC were 66% less likely than white patients to receive timely surgical intervention. Only 22.2% of Black male participants received surgery in a timely and appropriate manner compared to 43.7% of white male participants. Black patients with stage III NSCLC were 34% less likely to receive timely surgery, chemotherapy, or radiation. Black male participants with stage IV NSCLC were 51% less likely to receive chemotherapy in a timely manner than white male participants.
The researchers concluded that significant disparities exist for female and Black patients with NSCLC. Black patients are especially at risk of not receiving timely and appropriate care. A call to action is made for oncologists to acknowledge these racial and sex-related disparities. By being aware of and combating these disparities, all patients with NSCLC will be able to receive equitable treatment .
Source: Shugarman, L. R., Mack, K., Sorbero, M. E. S., Tian, H., Jain, A. K., Ashwood, J. S., & Asch, S. M. (2009). Race and sex differences in the receipt of timely and appropriate lung cancer treatment. Medical Care, 47(7), 774–781. https://doi.org/10.1097/mlr.0b013e3181a393fe