Racial Differences in Treatment and Survival among Veterans and Non-Veterans with Stage I NSCLC: An Evaluation of Veterans Affairs and SEER-Medicare Populations.


Journal

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
ISSN: 1538-7755
Titre abrégé: Cancer Epidemiol Biomarkers Prev
Pays: United States
ID NLM: 9200608

Informations de publication

Date de publication:
01 2020
Historique:
received: 20 03 2019
revised: 28 05 2019
accepted: 07 10 2019
pubmed: 19 10 2019
medline: 12 1 2021
entrez: 19 10 2019
Statut: ppublish

Résumé

Surgery is the preferred treatment for stage I non-small cell lung cancer (NSCLC), with radiation reserved for those not receiving surgery. Previous studies have shown lower rates of surgery among Blacks with stage I NSCLC than among Whites. Black and White men ages ≥65 years with stage I NSCLC diagnosed between 2001 and 2009 were identified in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database and Veterans Affairs (VA) cancer registry. Logistic regression and Cox proportional hazards models were used to examine associations between race, treatment, and survival. Among the patients in the VA ( Among VA and SEER-Medicare patients, Blacks were less likely to get surgical treatment. Blacks and Whites had similar survival outcomes when accounting for treatment. This supports the hypothesis that equal treatment correlates with equal outcomes and emphasizes the need to understand multilevel predictors of lung cancer treatment disparities.

Sections du résumé

BACKGROUND
Surgery is the preferred treatment for stage I non-small cell lung cancer (NSCLC), with radiation reserved for those not receiving surgery. Previous studies have shown lower rates of surgery among Blacks with stage I NSCLC than among Whites.
METHODS
Black and White men ages ≥65 years with stage I NSCLC diagnosed between 2001 and 2009 were identified in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database and Veterans Affairs (VA) cancer registry. Logistic regression and Cox proportional hazards models were used to examine associations between race, treatment, and survival.
RESULTS
Among the patients in the VA (
CONCLUSIONS
Among VA and SEER-Medicare patients, Blacks were less likely to get surgical treatment. Blacks and Whites had similar survival outcomes when accounting for treatment.
IMPACT
This supports the hypothesis that equal treatment correlates with equal outcomes and emphasizes the need to understand multilevel predictors of lung cancer treatment disparities.

Identifiants

pubmed: 31624076
pii: 1055-9965.EPI-19-0245
doi: 10.1158/1055-9965.EPI-19-0245
doi:

Substances chimiques

Antineoplastic Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

112-118

Informations de copyright

©2019 American Association for Cancer Research.

Auteurs

Christina D Williams (CD)

Cooperative Studies Program Epidemiology Center-Durham, Durham Veterans Affairs Health Care System, Durham, North Carolina. Christina.Williams4@va.gov.
Division of Medical Oncology, Department of Medicine, Duke University, Durham, North Carolina.

Naomi Alpert (N)

Department of Population Health Science and Policy, Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York.

Thomas S Redding (TS)

Cooperative Studies Program Epidemiology Center-Durham, Durham Veterans Affairs Health Care System, Durham, North Carolina.

A Jasmine Bullard (AJ)

Cooperative Studies Program Epidemiology Center-Durham, Durham Veterans Affairs Health Care System, Durham, North Carolina.

Raja M Flores (RM)

Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York.

Michael J Kelley (MJ)

Division of Medical Oncology, Department of Medicine, Duke University, Durham, North Carolina.
Division of Hematology-Oncology, Medical Service, Durham Veterans Affairs Health Care System, Durham, North Carolina.

Emanuela Taioli (E)

Department of Population Health Science and Policy, Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York.

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