Racial Disparities in Cancer Guideline-Concordant Treatment Using Surveillance, Epidemiology, and End Results Data for Patients With NSCLC
Introduction: Despite efforts to achieve health care equality, racial/ethnic disparities persist in lung cancer survival in the United States, with non-Hispanic Black patients experiencing higher mortality compared with non-Hispanic Whites. Previous research often focused on single treatments, overl...
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| Language: | English |
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Elsevier
2025-01-01
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| Series: | JTO Clinical and Research Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666364324001176 |
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| author | Eric Ababio Anyimadu, MS Jacklyn M. Engelbart, MD Jason Semprini, PhD Amanda Kahl, MPH Cameron Trentz, MS John M. Buatti, MD Thomas L. Casavant, PhD Mary E. Charlton, PhD Guadalupe Canahuate, PhD |
| author_facet | Eric Ababio Anyimadu, MS Jacklyn M. Engelbart, MD Jason Semprini, PhD Amanda Kahl, MPH Cameron Trentz, MS John M. Buatti, MD Thomas L. Casavant, PhD Mary E. Charlton, PhD Guadalupe Canahuate, PhD |
| author_sort | Eric Ababio Anyimadu, MS |
| collection | DOAJ |
| description | Introduction: Despite efforts to achieve health care equality, racial/ethnic disparities persist in lung cancer survival in the United States, with non-Hispanic Black patients experiencing higher mortality compared with non-Hispanic Whites. Previous research often focused on single treatments, overlooking the broad range of options available. We aimed to highlight disparities in survival and receipt of comprehensive lung cancer treatment by developing a guideline-concordant initial treatment (GCIT) indicator based on disease stage and recommended treatment. Methods: Using data of the Surveillance, Epidemiology, and End Results on 377,370 patients with NSCLC, we derived a GCIT indicator based on National Comprehensive Cancer Network guidelines. Observed probabilities and logistic regression models adjusted for age, disease stage, and race were used to assess racial disparities in treatment and survival, with the Kaplan-Meier method evaluating survival rates. Racial/ethnic groups analyzed included non-Hispanic White, non-Hispanic Black, Asian/Pacific Islander, Hispanic, and American Indian/Alaska Native. Results: Non-Hispanic Black patients had lower odds of receiving GCIT (OR = 0.80; 95% confidence interval [CI]: 0.78–0.82) and surviving 2 years after diagnosis (OR = 0.80; 95% CI: 0.78–0.82). Non-Hispanic Asians had the highest odds of receiving GCIT (OR = 1.02; 95% CI: 0.99–1.05). Patients receiving GCIT had improved survival, with early stage patients experiencing median survival of 67 to 102 months, compared with 11 to 17 months for those without GCIT. Conclusion: Receiving GCIT considerably improves survival across all races, though disparities in receipt are observed. Interventions are needed to ensure equitable access to guideline-concordant care and reduce survival disparities for patients. |
| format | Article |
| id | doaj-art-2cdeb65b1e6e4078be1e4c65f836a105 |
| institution | Kabale University |
| issn | 2666-3643 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTO Clinical and Research Reports |
| spelling | doaj-art-2cdeb65b1e6e4078be1e4c65f836a1052025-01-20T04:17:53ZengElsevierJTO Clinical and Research Reports2666-36432025-01-0161100747Racial Disparities in Cancer Guideline-Concordant Treatment Using Surveillance, Epidemiology, and End Results Data for Patients With NSCLCEric Ababio Anyimadu, MS0Jacklyn M. Engelbart, MD1Jason Semprini, PhD2Amanda Kahl, MPH3Cameron Trentz, MS4John M. Buatti, MD5Thomas L. Casavant, PhD6Mary E. Charlton, PhD7Guadalupe Canahuate, PhD8Department of Electrical and Computer Engineering, University of Iowa, Iowa City, IowaDepartment of Epidemiology, University of Iowa, Iowa City, Iowa; Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IowaDepartment of Public Health, Des Moines University, Des Moines, IowaDepartment of Epidemiology, University of Iowa, Iowa City, IowaDepartment of Electrical and Computer Engineering, University of Iowa, Iowa City, IowaDepartment of Radiation Oncology, University of Iowa, Iowa City, IowaDepartment of Electrical and Computer Engineering, University of Iowa, Iowa City, IowaDepartment of Epidemiology, University of Iowa, Iowa City, IowaDepartment of Electrical and Computer Engineering, University of Iowa, Iowa City, Iowa; Corresponding author. Address for correspondence: Guadalupe Canahuate, PhD, Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242.Introduction: Despite efforts to achieve health care equality, racial/ethnic disparities persist in lung cancer survival in the United States, with non-Hispanic Black patients experiencing higher mortality compared with non-Hispanic Whites. Previous research often focused on single treatments, overlooking the broad range of options available. We aimed to highlight disparities in survival and receipt of comprehensive lung cancer treatment by developing a guideline-concordant initial treatment (GCIT) indicator based on disease stage and recommended treatment. Methods: Using data of the Surveillance, Epidemiology, and End Results on 377,370 patients with NSCLC, we derived a GCIT indicator based on National Comprehensive Cancer Network guidelines. Observed probabilities and logistic regression models adjusted for age, disease stage, and race were used to assess racial disparities in treatment and survival, with the Kaplan-Meier method evaluating survival rates. Racial/ethnic groups analyzed included non-Hispanic White, non-Hispanic Black, Asian/Pacific Islander, Hispanic, and American Indian/Alaska Native. Results: Non-Hispanic Black patients had lower odds of receiving GCIT (OR = 0.80; 95% confidence interval [CI]: 0.78–0.82) and surviving 2 years after diagnosis (OR = 0.80; 95% CI: 0.78–0.82). Non-Hispanic Asians had the highest odds of receiving GCIT (OR = 1.02; 95% CI: 0.99–1.05). Patients receiving GCIT had improved survival, with early stage patients experiencing median survival of 67 to 102 months, compared with 11 to 17 months for those without GCIT. Conclusion: Receiving GCIT considerably improves survival across all races, though disparities in receipt are observed. Interventions are needed to ensure equitable access to guideline-concordant care and reduce survival disparities for patients.http://www.sciencedirect.com/science/article/pii/S2666364324001176DisparitiesNon–small cell lung cancerGuideline-concordant initial treatmentSurvival |
| spellingShingle | Eric Ababio Anyimadu, MS Jacklyn M. Engelbart, MD Jason Semprini, PhD Amanda Kahl, MPH Cameron Trentz, MS John M. Buatti, MD Thomas L. Casavant, PhD Mary E. Charlton, PhD Guadalupe Canahuate, PhD Racial Disparities in Cancer Guideline-Concordant Treatment Using Surveillance, Epidemiology, and End Results Data for Patients With NSCLC JTO Clinical and Research Reports Disparities Non–small cell lung cancer Guideline-concordant initial treatment Survival |
| title | Racial Disparities in Cancer Guideline-Concordant Treatment Using Surveillance, Epidemiology, and End Results Data for Patients With NSCLC |
| title_full | Racial Disparities in Cancer Guideline-Concordant Treatment Using Surveillance, Epidemiology, and End Results Data for Patients With NSCLC |
| title_fullStr | Racial Disparities in Cancer Guideline-Concordant Treatment Using Surveillance, Epidemiology, and End Results Data for Patients With NSCLC |
| title_full_unstemmed | Racial Disparities in Cancer Guideline-Concordant Treatment Using Surveillance, Epidemiology, and End Results Data for Patients With NSCLC |
| title_short | Racial Disparities in Cancer Guideline-Concordant Treatment Using Surveillance, Epidemiology, and End Results Data for Patients With NSCLC |
| title_sort | racial disparities in cancer guideline concordant treatment using surveillance epidemiology and end results data for patients with nsclc |
| topic | Disparities Non–small cell lung cancer Guideline-concordant initial treatment Survival |
| url | http://www.sciencedirect.com/science/article/pii/S2666364324001176 |
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