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Impact of Race on Treatment and Survival among U.S. Veterans with Early-Stage Lung Cancer.

Publication ,  Journal Article
Williams, CD; Salama, JK; Moghanaki, D; Karas, TZ; Kelley, MJ
Published in: J Thorac Oncol
October 2016

INTRODUCTION: Numerous reports suggest lower rates of surgical procedures and poorer survival for black patients with early-stage (stage I or II) NSCLC than for white patients. This study examined treatment trends among blacks and whites with early-stage NSCLC and determined whether racial disparities exist in survival among patients receiving similar treatment. METHODS: A retrospective analysis of 18,466 patients in the Veteran Affairs Central Cancer Registry in whom stage I or II NSCLC was diagnosed in 2001-2010 was conducted. Patients were categorized as receiving an operation, radiation, or other/no treatment. Overall survival (OS) and lung cancer-specific survival (LCSS) were evaluated using Kaplan-Meier and multivariable Cox regression analyses. RESULTS: There was a statistically significant disparity between black and white patients receiving an operation that decreased over time to similar rates (p = 0.01). No significant racial differences in receipt of radiation were noted. Race was not associated with OS among all patients (hazard ratio [HR] = 0.97, 95% confidence interval [CI]: 0.93-1.02). Among patients who received an operation, no racial difference in OS was observed (HR = 0.94, 95% CI: 0.87-1.01), but the HR for blacks versus whites was 0.90 (95% CI: 0.82-0.98) for radiation treatment and 0.89 (95% CI: 0.81-0.97) for other/no treatment. Race was not associated with LCSS among all patients combined or within each treatment category. CONCLUSIONS: A racial disparity in the rate of operation was no longer apparent at the end of the study period. There was no racial difference in OS or LCSS among all patients in this equal access health care system. Long-documented racial differences in lung cancer treatment and mortality result from disparity of access to health care and delivery of recommended treatment.

Duke Scholars

Published In

J Thorac Oncol

DOI

EISSN

1556-1380

Publication Date

October 2016

Volume

11

Issue

10

Start / End Page

1672 / 1681

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Treatment Outcome
  • Survival Rate
  • Retrospective Studies
  • Racial Groups
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Williams, C. D., Salama, J. K., Moghanaki, D., Karas, T. Z., & Kelley, M. J. (2016). Impact of Race on Treatment and Survival among U.S. Veterans with Early-Stage Lung Cancer. J Thorac Oncol, 11(10), 1672–1681. https://doi.org/10.1016/j.jtho.2016.05.030
Williams, Christina D., Joseph K. Salama, Drew Moghanaki, Tomer Z. Karas, and Michael J. Kelley. “Impact of Race on Treatment and Survival among U.S. Veterans with Early-Stage Lung Cancer.J Thorac Oncol 11, no. 10 (October 2016): 1672–81. https://doi.org/10.1016/j.jtho.2016.05.030.
Williams CD, Salama JK, Moghanaki D, Karas TZ, Kelley MJ. Impact of Race on Treatment and Survival among U.S. Veterans with Early-Stage Lung Cancer. J Thorac Oncol. 2016 Oct;11(10):1672–81.
Williams, Christina D., et al. “Impact of Race on Treatment and Survival among U.S. Veterans with Early-Stage Lung Cancer.J Thorac Oncol, vol. 11, no. 10, Oct. 2016, pp. 1672–81. Pubmed, doi:10.1016/j.jtho.2016.05.030.
Williams CD, Salama JK, Moghanaki D, Karas TZ, Kelley MJ. Impact of Race on Treatment and Survival among U.S. Veterans with Early-Stage Lung Cancer. J Thorac Oncol. 2016 Oct;11(10):1672–1681.
Journal cover image

Published In

J Thorac Oncol

DOI

EISSN

1556-1380

Publication Date

October 2016

Volume

11

Issue

10

Start / End Page

1672 / 1681

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Treatment Outcome
  • Survival Rate
  • Retrospective Studies
  • Racial Groups
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Middle Aged
  • Male