Chest
Original Research: Lung CancerRacial and Ethnic Disparities in Early-Stage Lung Cancer Survival
Section snippets
Methods
We obtained survival time data for patients with lung cancer from the Surveillance, Epidemiology, and End-Results (SEER) 18 registry database from 2004 to 2013. The SEER 18 registries, which cover approximately 25% of the US population, form the largest, most representative, and longest running national cancer incidence database. We analyzed 105,121 Hispanic, non-Hispanic Asian and Pacific Islander (hereafter referred to as Asian), non-Hispanic black (hereafter referred to as black), and
Patient Characteristics
Between 2004 and 2013, 4,412 Hispanic, 4,833 Asian, 10,038 black, and 85,838 white patients residing in SEER registry areas were diagnosed with stage IA, IB, IIA, or IIB lung cancer (early stage) (Table 1). The modal age at diagnosis was 70 to 74 years for Hispanics, Asians, and whites and 65 to 69 years for blacks. The proportion of patients with early-stage lung cancer diagnosed as stage IA was highest for whites (46%) and lowest for blacks (41%). Finally, adenocarcinoma was the most commonly
Discussion
Our study assessed racial and ethnic disparities in survival, both overall and by cause (lung cancer and all other diseases) among patients with early-stage lung cancer. First, surgery was recommended less often for black patients with early-stage lung cancer than for other racial/ethnic groups. Second, black patients with early-stage lung cancer who received lung cancer surgery still experienced worse overall survival than did their whites counterparts. Third, the source of this disparity in
Conclusions
We found that worse survival from competing causes of death, rather than from lung cancer itself, led to disparities in overall survival among black and white patients with early-stage lung cancer. In contrast, better survival from competing causes of death led to the overall survival advantage of Hispanic and Asian patients with early-stage lung cancer compared with their white counterparts. Narrowing racial disparities in survival among patients with early-stage lung cancer will rely on more
Acknowledgments
Author contributions: S. S., G. A. S., N. T. T., C. S. L., and W. B. were involved in the study design and preparation of the article. S. S. was involved in the data collection and statistical analysis.
Financial/nonfinancial disclosures: None declared.
Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript.
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FUNDING/SUPPORT: This work was supported by the National Institutes of Health (R21-CA197912 to S. S.) and the American Lung Association (to S. S.).