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Socioeconomic disparities in immunotherapy use among advanced-stage non-small cell lung cancer patients: analysis of the National Cancer Database.

Publication ,  Journal Article
Gupta, A; Omeogu, C; Islam, JY; Joshi, A; Zhang, D; Braithwaite, D; Karanth, SD; Tailor, TD; Clarke, JM; Akinyemiju, T
Published in: Sci Rep
May 20, 2023

Socioeconomic and racial disparities exist in access to care among patients with non-small cell lung cancer (NSCLC) in the United States. Immunotherapy is a widely established treatment modality for patients with advanced-stage NSCLC (aNSCLC). We examined associations of area-level socioeconomic status with receipt of immunotherapy for aNSCLC patients by race/ethnicity and cancer facility type (academic and non-academic). We used the National Cancer Database (2015-2016), and included patients aged 40-89 years who were diagnosed with stage III-IV NSCLC. Area-level income was defined as the median household income in the patient's zip code, and area-level education was defined as the proportion of adults aged ≥ 25 years in the patient's zip code without a high school degree. We calculated adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) using multi-level multivariable logistic regression. Among 100,298 aNSCLC patients, lower area-level education and income were associated with lower odds of immunotherapy treatment (education: aOR 0.71; 95% CI 0.65, 0.76 and income: aOR 0.71; 95% CI 0.66, 0.77). These associations persisted for NH-White patients. However, among NH-Black patients, we only observed an association with lower education (aOR 0.74; 95% CI 0.57, 0.97). Across all cancer facility types, lower education and income were associated with lower immunotherapy receipt among NH-White patients. However, among NH-Black patients, this association only persisted with education for patients treated at non-academic facilities (aOR 0.70; 95% CI 0.49, 0.99). In conclusion, aNSCLC patients residing in areas of lower educational and economic wealth were less likely to receive immunotherapy.

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Published In

Sci Rep

DOI

EISSN

2045-2322

Publication Date

May 20, 2023

Volume

13

Issue

1

Start / End Page

8190

Location

England

Related Subject Headings

  • United States
  • Socioeconomic Factors
  • Socioeconomic Disparities in Health
  • Lung Neoplasms
  • Immunotherapy
  • Humans
  • Healthcare Disparities
  • Carcinoma, Non-Small-Cell Lung
  • Adult
 

Citation

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Gupta, A., Omeogu, C., Islam, J. Y., Joshi, A., Zhang, D., Braithwaite, D., … Akinyemiju, T. (2023). Socioeconomic disparities in immunotherapy use among advanced-stage non-small cell lung cancer patients: analysis of the National Cancer Database. Sci Rep, 13(1), 8190. https://doi.org/10.1038/s41598-023-35216-2
Gupta, Anjali, Chioma Omeogu, Jessica Y. Islam, Ashwini Joshi, Dongyu Zhang, Dejana Braithwaite, Shama D. Karanth, Tina D. Tailor, Jeffrey M. Clarke, and Tomi Akinyemiju. “Socioeconomic disparities in immunotherapy use among advanced-stage non-small cell lung cancer patients: analysis of the National Cancer Database.Sci Rep 13, no. 1 (May 20, 2023): 8190. https://doi.org/10.1038/s41598-023-35216-2.
Gupta A, Omeogu C, Islam JY, Joshi A, Zhang D, Braithwaite D, et al. Socioeconomic disparities in immunotherapy use among advanced-stage non-small cell lung cancer patients: analysis of the National Cancer Database. Sci Rep. 2023 May 20;13(1):8190.
Gupta, Anjali, et al. “Socioeconomic disparities in immunotherapy use among advanced-stage non-small cell lung cancer patients: analysis of the National Cancer Database.Sci Rep, vol. 13, no. 1, May 2023, p. 8190. Pubmed, doi:10.1038/s41598-023-35216-2.
Gupta A, Omeogu C, Islam JY, Joshi A, Zhang D, Braithwaite D, Karanth SD, Tailor TD, Clarke JM, Akinyemiju T. Socioeconomic disparities in immunotherapy use among advanced-stage non-small cell lung cancer patients: analysis of the National Cancer Database. Sci Rep. 2023 May 20;13(1):8190.

Published In

Sci Rep

DOI

EISSN

2045-2322

Publication Date

May 20, 2023

Volume

13

Issue

1

Start / End Page

8190

Location

England

Related Subject Headings

  • United States
  • Socioeconomic Factors
  • Socioeconomic Disparities in Health
  • Lung Neoplasms
  • Immunotherapy
  • Humans
  • Healthcare Disparities
  • Carcinoma, Non-Small-Cell Lung
  • Adult