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Impact of race on early-stage lung cancer treatment and survival.

Publication ,  Journal Article
Provenzale, DT; Stechuchak, KM; Kelley, MJ
Published in: J Clin Oncol
December 2012

232 Background: Studies have documented racial differences along the lung cancer continuum and equity in care is essential to quality improvement. The purpose of this study was to investigate the influence of race on lung cancer treatment and survival among early-stage non-small cell lung cancer patients in an equal access healthcare system. We hypothesize that patients receiving similar treatment will have similar survival. METHODS: Data were from the External Peer Review Program (EPRP) Lung Cancer Special Study, which was a cross-sectional study conducted to assess the quality of care among patients diagnosed with lung cancer and receiving care at a VA facility. All patients were diagnosed between October 1, 2006 and December 31, 2007. Analyses were restricted to patients with Stage I/II NSCLC (n=1,426; 1,229 whites, 197 blacks). Multivariate logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: The proportion of blacks who had surgery was significantly less than that among whites (OR: 0.56, 95% CI 0.39-0.79). There was no racial difference in receipt of adjuvant therapy (chemotherapy and/or radiation therapy) among patients who had surgery (p=0.08). Among patients who did not undergo surgery, blacks were more likely to refuse surgery (OR: 2.30, 95% CI 1.29-4.13); however, the proportion of patients with contraindications to surgery and those receiving palliative treatment were similar in both race groups. The 2-year survival rate was 69% and race was not a predictor of survival when controlling for receipt of surgery along with other covariates (p=0.76). The 2-year survival rate was 82% among patients who had surgery, and 48% among patients who did not have surgery. Specifically among patients who did not have surgery due to refusal, the survival rate was 55%. CONCLUSIONS: We observed a racial disparity in surgery, partially due to the greater rate of refusal among blacks, but not adjuvant or palliative treatment. Race did not have a major impact on 2-year survival for patients with early-stage lung cancer. These findings stress the need to better understand patient preferences regarding surgery and identify ways to reduce this variation in surgery to improve quality of lung cancer care.

Duke Scholars

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

December 2012

Volume

30

Issue

34_suppl

Start / End Page

232

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

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Chicago
ICMJE
MLA
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Provenzale, D. T., Stechuchak, K. M., & Kelley, M. J. (2012). Impact of race on early-stage lung cancer treatment and survival. J Clin Oncol, 30(34_suppl), 232. https://doi.org/10.1200/jco.2012.30.34_suppl.232
Provenzale, D. T., K. M. Stechuchak, and M. J. Kelley. “Impact of race on early-stage lung cancer treatment and survival.J Clin Oncol 30, no. 34_suppl (December 2012): 232. https://doi.org/10.1200/jco.2012.30.34_suppl.232.
Provenzale DT, Stechuchak KM, Kelley MJ. Impact of race on early-stage lung cancer treatment and survival. J Clin Oncol. 2012 Dec;30(34_suppl):232.
Provenzale, D. T., et al. “Impact of race on early-stage lung cancer treatment and survival.J Clin Oncol, vol. 30, no. 34_suppl, Dec. 2012, p. 232. Pubmed, doi:10.1200/jco.2012.30.34_suppl.232.
Provenzale DT, Stechuchak KM, Kelley MJ. Impact of race on early-stage lung cancer treatment and survival. J Clin Oncol. 2012 Dec;30(34_suppl):232.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

December 2012

Volume

30

Issue

34_suppl

Start / End Page

232

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences