Do racial or socioeconomic disparities exist in lung cancer treatment?
BACKGROUND: Determine the effects of race, socioeconomic status, and treatment on outcomes for patients diagnosed with lung cancer. METHODS: The Florida cancer registry and inpatient and ambulatory data were queried for patients diagnosed from 1998‐2002. RESULTS: A total 76,086 of lung cancer patien...
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| Veröffentlicht in: | Cancer 2010-05, Vol.116 (10), p.2437-2447 |
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| creator | Yang, Relin Cheung, Michael C. Byrne, Margaret M. Huang, Youjie Nguyen, Dao Lally, Brian E. Koniaris, Leonidas G. |
| description | BACKGROUND:
Determine the effects of race, socioeconomic status, and treatment on outcomes for patients diagnosed with lung cancer.
METHODS:
The Florida cancer registry and inpatient and ambulatory data were queried for patients diagnosed from 1998‐2002.
RESULTS:
A total 76,086 of lung cancer patients were identified. Overall, 55.6% were male and 44.4% were female. The demographic distribution of patients was 92.7% Caucasian, 6.7% African American, and 5.7% Hispanic. The mean age of diagnosis was 70 years old. African American patients presented at a younger age, with more advanced disease, and were less likely to undergo surgical therapy than their Caucasian counterparts. Median survival time (MST) for the entire cohort was 8.7 months, while MST for African American patients was 7.5 months. Patients who received surgery, chemotherapy, or radiation therapy demonstrated significantly improved outcomes. Stepwise multivariate analysis revealed that African American race was no longer a statistically significant predictor of worse outcomes once corrections were made for demographics and comorbid conditions, suggesting that the originally reported disparities in lung cancer outcomes and race may be in part because of poor pretreatment performance status. In contrast, patients of the lowest socioeconomic status continue to have a slightly worse overall prognosis than their affluent counterparts (hazard ratio = 1.05, P = .001).
CONCLUSIONS:
Lung cancer continues to carry a poor prognosis for all patients. Once comorbidities are corrected for, African American patients carry equivalently poor outcomes. Nonetheless, emphasis must be placed on improving pretreatment performance status among African American patients and efforts for earlier diagnosis among the impoverished patients must be made. Cancer 2010. © 2010 American Cancer Society.
Lung cancer continues to carry a poor prognosis for all patients. Once comorbidities are corrected for, African American patients carry equivalently poor outcomes. |
| doi_str_mv | 10.1002/cncr.24986 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_733516197</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>733516197</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3946-990bd1101e57f341d5638a1ebb26722731f714c4d579ffe1077c4d6d31f03c5d3</originalsourceid><addsrcrecordid>eNp90M9LwzAUwPEgips_Lv4BkosIQmde0ibrSaQ6FYaCKHgLWZpKpG1m0qL7783s1Jun8MKH9-CL0BGQCRBCz3Wr_YSm-ZRvoTGQXCQEUrqNxoSQaZKl7GWE9kJ4i6OgGdtFI0ooyTnwMZpdOeyVtqrGzuPgtHVGu9Y1VuPShqXytrMmYPNpQ4dti-u-fcVatdp43Hmjusa03cUB2qlUHczh5t1Hz7Prp-I2mT_c3BWX80SzPOVJnpNFCUDAZKJiKZQZZ1MFZrGgXFAqGFQCUp2WmcirygARIg68jP-E6axk--h02Lv07r03oZONDdrUtWqN64MUjGXAIRdRng1SexeCN5Vcetsov5JA5DqbXGeT39kiPt6s7ReNKX_pT6cITjZABa3qyscANvw5KmJqRqODwX3Y2qz-OSmL--JxOP4F9_CD0Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>733516197</pqid></control><display><type>article</type><title>Do racial or socioeconomic disparities exist in lung cancer treatment?</title><source>MEDLINE</source><source>Wiley Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Wiley Free Content</source><source>Alma/SFX Local Collection</source><creator>Yang, Relin ; Cheung, Michael C. ; Byrne, Margaret M. ; Huang, Youjie ; Nguyen, Dao ; Lally, Brian E. ; Koniaris, Leonidas G.</creator><creatorcontrib>Yang, Relin ; Cheung, Michael C. ; Byrne, Margaret M. ; Huang, Youjie ; Nguyen, Dao ; Lally, Brian E. ; Koniaris, Leonidas G.</creatorcontrib><description>BACKGROUND:
Determine the effects of race, socioeconomic status, and treatment on outcomes for patients diagnosed with lung cancer.
METHODS:
The Florida cancer registry and inpatient and ambulatory data were queried for patients diagnosed from 1998‐2002.
RESULTS:
A total 76,086 of lung cancer patients were identified. Overall, 55.6% were male and 44.4% were female. The demographic distribution of patients was 92.7% Caucasian, 6.7% African American, and 5.7% Hispanic. The mean age of diagnosis was 70 years old. African American patients presented at a younger age, with more advanced disease, and were less likely to undergo surgical therapy than their Caucasian counterparts. Median survival time (MST) for the entire cohort was 8.7 months, while MST for African American patients was 7.5 months. Patients who received surgery, chemotherapy, or radiation therapy demonstrated significantly improved outcomes. Stepwise multivariate analysis revealed that African American race was no longer a statistically significant predictor of worse outcomes once corrections were made for demographics and comorbid conditions, suggesting that the originally reported disparities in lung cancer outcomes and race may be in part because of poor pretreatment performance status. In contrast, patients of the lowest socioeconomic status continue to have a slightly worse overall prognosis than their affluent counterparts (hazard ratio = 1.05, P = .001).
CONCLUSIONS:
Lung cancer continues to carry a poor prognosis for all patients. Once comorbidities are corrected for, African American patients carry equivalently poor outcomes. Nonetheless, emphasis must be placed on improving pretreatment performance status among African American patients and efforts for earlier diagnosis among the impoverished patients must be made. Cancer 2010. © 2010 American Cancer Society.
Lung cancer continues to carry a poor prognosis for all patients. Once comorbidities are corrected for, African American patients carry equivalently poor outcomes.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.24986</identifier><identifier>PMID: 20209616</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Aged ; Biological and medical sciences ; Comorbidity ; Continental Population Groups ; Databases as Topic ; disparity ; Ethnic Groups ; Female ; Florida ; Healthcare Disparities ; Humans ; lung cancer ; Lung Neoplasms - economics ; Lung Neoplasms - ethnology ; Lung Neoplasms - mortality ; Lung Neoplasms - therapy ; Male ; Medical sciences ; Middle Aged ; outcomes ; Pneumology ; Poverty ; race ; Social Class ; socioeconomic status ; Tumors ; Tumors of the respiratory system and mediastinum</subject><ispartof>Cancer, 2010-05, Vol.116 (10), p.2437-2447</ispartof><rights>Copyright © 2010 American Cancer Society</rights><rights>2015 INIST-CNRS</rights><rights>(c) 2010 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3946-990bd1101e57f341d5638a1ebb26722731f714c4d579ffe1077c4d6d31f03c5d3</citedby><cites>FETCH-LOGICAL-c3946-990bd1101e57f341d5638a1ebb26722731f714c4d579ffe1077c4d6d31f03c5d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.24986$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.24986$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22700832$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20209616$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Relin</creatorcontrib><creatorcontrib>Cheung, Michael C.</creatorcontrib><creatorcontrib>Byrne, Margaret M.</creatorcontrib><creatorcontrib>Huang, Youjie</creatorcontrib><creatorcontrib>Nguyen, Dao</creatorcontrib><creatorcontrib>Lally, Brian E.</creatorcontrib><creatorcontrib>Koniaris, Leonidas G.</creatorcontrib><title>Do racial or socioeconomic disparities exist in lung cancer treatment?</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND:
Determine the effects of race, socioeconomic status, and treatment on outcomes for patients diagnosed with lung cancer.
METHODS:
The Florida cancer registry and inpatient and ambulatory data were queried for patients diagnosed from 1998‐2002.
RESULTS:
A total 76,086 of lung cancer patients were identified. Overall, 55.6% were male and 44.4% were female. The demographic distribution of patients was 92.7% Caucasian, 6.7% African American, and 5.7% Hispanic. The mean age of diagnosis was 70 years old. African American patients presented at a younger age, with more advanced disease, and were less likely to undergo surgical therapy than their Caucasian counterparts. Median survival time (MST) for the entire cohort was 8.7 months, while MST for African American patients was 7.5 months. Patients who received surgery, chemotherapy, or radiation therapy demonstrated significantly improved outcomes. Stepwise multivariate analysis revealed that African American race was no longer a statistically significant predictor of worse outcomes once corrections were made for demographics and comorbid conditions, suggesting that the originally reported disparities in lung cancer outcomes and race may be in part because of poor pretreatment performance status. In contrast, patients of the lowest socioeconomic status continue to have a slightly worse overall prognosis than their affluent counterparts (hazard ratio = 1.05, P = .001).
CONCLUSIONS:
Lung cancer continues to carry a poor prognosis for all patients. Once comorbidities are corrected for, African American patients carry equivalently poor outcomes. Nonetheless, emphasis must be placed on improving pretreatment performance status among African American patients and efforts for earlier diagnosis among the impoverished patients must be made. Cancer 2010. © 2010 American Cancer Society.
Lung cancer continues to carry a poor prognosis for all patients. Once comorbidities are corrected for, African American patients carry equivalently poor outcomes.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Comorbidity</subject><subject>Continental Population Groups</subject><subject>Databases as Topic</subject><subject>disparity</subject><subject>Ethnic Groups</subject><subject>Female</subject><subject>Florida</subject><subject>Healthcare Disparities</subject><subject>Humans</subject><subject>lung cancer</subject><subject>Lung Neoplasms - economics</subject><subject>Lung Neoplasms - ethnology</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>outcomes</subject><subject>Pneumology</subject><subject>Poverty</subject><subject>race</subject><subject>Social Class</subject><subject>socioeconomic status</subject><subject>Tumors</subject><subject>Tumors of the respiratory system and mediastinum</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90M9LwzAUwPEgips_Lv4BkosIQmde0ibrSaQ6FYaCKHgLWZpKpG1m0qL7783s1Jun8MKH9-CL0BGQCRBCz3Wr_YSm-ZRvoTGQXCQEUrqNxoSQaZKl7GWE9kJ4i6OgGdtFI0ooyTnwMZpdOeyVtqrGzuPgtHVGu9Y1VuPShqXytrMmYPNpQ4dti-u-fcVatdp43Hmjusa03cUB2qlUHczh5t1Hz7Prp-I2mT_c3BWX80SzPOVJnpNFCUDAZKJiKZQZZ1MFZrGgXFAqGFQCUp2WmcirygARIg68jP-E6axk--h02Lv07r03oZONDdrUtWqN64MUjGXAIRdRng1SexeCN5Vcetsov5JA5DqbXGeT39kiPt6s7ReNKX_pT6cITjZABa3qyscANvw5KmJqRqODwX3Y2qz-OSmL--JxOP4F9_CD0Q</recordid><startdate>20100515</startdate><enddate>20100515</enddate><creator>Yang, Relin</creator><creator>Cheung, Michael C.</creator><creator>Byrne, Margaret M.</creator><creator>Huang, Youjie</creator><creator>Nguyen, Dao</creator><creator>Lally, Brian E.</creator><creator>Koniaris, Leonidas G.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100515</creationdate><title>Do racial or socioeconomic disparities exist in lung cancer treatment?</title><author>Yang, Relin ; Cheung, Michael C. ; Byrne, Margaret M. ; Huang, Youjie ; Nguyen, Dao ; Lally, Brian E. ; Koniaris, Leonidas G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3946-990bd1101e57f341d5638a1ebb26722731f714c4d579ffe1077c4d6d31f03c5d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Comorbidity</topic><topic>Continental Population Groups</topic><topic>Databases as Topic</topic><topic>disparity</topic><topic>Ethnic Groups</topic><topic>Female</topic><topic>Florida</topic><topic>Healthcare Disparities</topic><topic>Humans</topic><topic>lung cancer</topic><topic>Lung Neoplasms - economics</topic><topic>Lung Neoplasms - ethnology</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>outcomes</topic><topic>Pneumology</topic><topic>Poverty</topic><topic>race</topic><topic>Social Class</topic><topic>socioeconomic status</topic><topic>Tumors</topic><topic>Tumors of the respiratory system and mediastinum</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Relin</creatorcontrib><creatorcontrib>Cheung, Michael C.</creatorcontrib><creatorcontrib>Byrne, Margaret M.</creatorcontrib><creatorcontrib>Huang, Youjie</creatorcontrib><creatorcontrib>Nguyen, Dao</creatorcontrib><creatorcontrib>Lally, Brian E.</creatorcontrib><creatorcontrib>Koniaris, Leonidas G.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Relin</au><au>Cheung, Michael C.</au><au>Byrne, Margaret M.</au><au>Huang, Youjie</au><au>Nguyen, Dao</au><au>Lally, Brian E.</au><au>Koniaris, Leonidas G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Do racial or socioeconomic disparities exist in lung cancer treatment?</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2010-05-15</date><risdate>2010</risdate><volume>116</volume><issue>10</issue><spage>2437</spage><epage>2447</epage><pages>2437-2447</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND:
Determine the effects of race, socioeconomic status, and treatment on outcomes for patients diagnosed with lung cancer.
METHODS:
The Florida cancer registry and inpatient and ambulatory data were queried for patients diagnosed from 1998‐2002.
RESULTS:
A total 76,086 of lung cancer patients were identified. Overall, 55.6% were male and 44.4% were female. The demographic distribution of patients was 92.7% Caucasian, 6.7% African American, and 5.7% Hispanic. The mean age of diagnosis was 70 years old. African American patients presented at a younger age, with more advanced disease, and were less likely to undergo surgical therapy than their Caucasian counterparts. Median survival time (MST) for the entire cohort was 8.7 months, while MST for African American patients was 7.5 months. Patients who received surgery, chemotherapy, or radiation therapy demonstrated significantly improved outcomes. Stepwise multivariate analysis revealed that African American race was no longer a statistically significant predictor of worse outcomes once corrections were made for demographics and comorbid conditions, suggesting that the originally reported disparities in lung cancer outcomes and race may be in part because of poor pretreatment performance status. In contrast, patients of the lowest socioeconomic status continue to have a slightly worse overall prognosis than their affluent counterparts (hazard ratio = 1.05, P = .001).
CONCLUSIONS:
Lung cancer continues to carry a poor prognosis for all patients. Once comorbidities are corrected for, African American patients carry equivalently poor outcomes. Nonetheless, emphasis must be placed on improving pretreatment performance status among African American patients and efforts for earlier diagnosis among the impoverished patients must be made. Cancer 2010. © 2010 American Cancer Society.
Lung cancer continues to carry a poor prognosis for all patients. Once comorbidities are corrected for, African American patients carry equivalently poor outcomes.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>20209616</pmid><doi>10.1002/cncr.24986</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Biological and medical sciences Comorbidity Continental Population Groups Databases as Topic disparity Ethnic Groups Female Florida Healthcare Disparities Humans lung cancer Lung Neoplasms - economics Lung Neoplasms - ethnology Lung Neoplasms - mortality Lung Neoplasms - therapy Male Medical sciences Middle Aged outcomes Pneumology Poverty race Social Class socioeconomic status Tumors Tumors of the respiratory system and mediastinum |
| title | Do racial or socioeconomic disparities exist in lung cancer treatment? |
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