Previous research has shown that Black patients with early-stage non-small cell lung cancer (NSCLC) experience worse overall survival than white patients. In an effort to rectify this disparity, researchers from the Dana-Farber Cancer Institute sought to determine why Black patients with NSCLC are less likely to undergo surgical treatment.
The researchers used ten years of Medicare data that included patients diagnosed with nonmetastatic NSCLC. The odds of having invasive staging and surgery were calculated, as were survival outcomes.
Ultimately, it was found that 14,224 patients underwent staging, and 6,972 had surgery. Black patients were 25% less likely to undergo staging, and those who did were still 45% less likely to have surgery than white patients. However, Black patients who did undergo surgery seemed to experience the same survival outcomes as white patients.
In addition, Black patients who underwent staging were significantly less likely to receive a recommendation for surgery when it was not contraindicated. They were also significantly more likely to decline surgery when it was offered to them.
The researchers concluded that significant racial disparities exist for Black patients with NSCLC. These disparities still exist even when there is equal access to care. Black patients are less likely to receive surgical recommendations and more likely to decline surgery.
A call to action is made for oncologists to better engage and educate Black patients with NSCLC on their treatment plans. Further research studying the physician-patient encounter as a potential source of disparity is needed .
Source: Lathan, C. S., Neville, B. A., & Earle, C. C. (2006). The effect of race on invasive staging and surgery in non–small-cell lung cancer. Journal of Clinical Oncology, 24(3), 413–418. https://doi.org/10.1200/jco.2005.02.1758