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Racial and ethnic inequities of palliative care use among advanced Non-Small cell lung cancer patients in the US.

Publication ,  Journal Article
Islam, JY; Braithwaite, D; Zhang, D; Guo, Y; Tailor, TD; Akinyemiju, T
Published in: Cancer Med
April 2023

BACKGROUND: With early intervention, palliative care (PC) can improve quality of life and increase survival among advanced-stage non-small cell lung cancer (aNCSLC) patients. However, PC is often offered late in the cancer treatment course and is underused. We characterized racial/ethnic inequities and the role of healthcare access in PC use among patients with aNSCLC. METHODS: We used data from the 2004-2016 National Cancer Database, including adults aged 18-90 years with aNSCLC (stage 3 or 4 at diagnosis; n = 803,618). Based on the NCCN guidelines, PC includes non-curative surgery, radiation, chemotherapy, pain management, or any combination of non-curative care. We examined PC use by sociodemographic and health care-level characteristics. To evaluate the independent associations of race/ethnicity and health care access characteristics with PC, we estimated adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). Covariate adjustment sets varied by exposure determined using directed acyclic graphs. RESULTS: Our population was 55% male and 77% non-Hispanic/Latinx (NH)-White, with a mean age of 68 years. Overall, 19% of patients with aNSCLC used PC. Compared to NH-White patients, NH-Black (aOR:0.91,95% CI:0.89-0.93) and Hispanic/Latinx (aOR:0.80,95% CI:0.77-0.83) patients were less likely to use PC, whereas Indigenous (AI/AN) (aOR:1.18,95% CI:1.06-1.31) and Native Hawaiian/Pacific Islander (aOR:2.08,95% CI:1.83-2.36) patients were more likely. Overall, compared to the privately-insured, uninsured (aOR:1.19,95% CI:1.11-1.28) and Medicaid-insured patients (aOR:1.19,95% CI:1.14-1.25) were more likely to use PC. CONCLUSION: PC is underutilized among NH-Black and Hispanic/Latinx patients with aNSCLC. Insurance type may play a role in PC use among patients with aNSCLC.

Duke Scholars

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Published In

Cancer Med

DOI

EISSN

2045-7634

Publication Date

April 2023

Volume

12

Issue

7

Start / End Page

8567 / 8580

Location

United States

Related Subject Headings

  • United States
  • Quality of Life
  • Palliative Care
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Ethnicity
  • Carcinoma, Non-Small-Cell Lung
  • Aged
 

Citation

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Islam, J. Y., Braithwaite, D., Zhang, D., Guo, Y., Tailor, T. D., & Akinyemiju, T. (2023). Racial and ethnic inequities of palliative care use among advanced Non-Small cell lung cancer patients in the US. Cancer Med, 12(7), 8567–8580. https://doi.org/10.1002/cam4.5538
Islam, Jessica Y., Dejana Braithwaite, Dongyu Zhang, Yi Guo, Tina D. Tailor, and Tomi Akinyemiju. “Racial and ethnic inequities of palliative care use among advanced Non-Small cell lung cancer patients in the US.Cancer Med 12, no. 7 (April 2023): 8567–80. https://doi.org/10.1002/cam4.5538.
Islam JY, Braithwaite D, Zhang D, Guo Y, Tailor TD, Akinyemiju T. Racial and ethnic inequities of palliative care use among advanced Non-Small cell lung cancer patients in the US. Cancer Med. 2023 Apr;12(7):8567–80.
Islam, Jessica Y., et al. “Racial and ethnic inequities of palliative care use among advanced Non-Small cell lung cancer patients in the US.Cancer Med, vol. 12, no. 7, Apr. 2023, pp. 8567–80. Pubmed, doi:10.1002/cam4.5538.
Islam JY, Braithwaite D, Zhang D, Guo Y, Tailor TD, Akinyemiju T. Racial and ethnic inequities of palliative care use among advanced Non-Small cell lung cancer patients in the US. Cancer Med. 2023 Apr;12(7):8567–8580.
Journal cover image

Published In

Cancer Med

DOI

EISSN

2045-7634

Publication Date

April 2023

Volume

12

Issue

7

Start / End Page

8567 / 8580

Location

United States

Related Subject Headings

  • United States
  • Quality of Life
  • Palliative Care
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Ethnicity
  • Carcinoma, Non-Small-Cell Lung
  • Aged