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 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 87 months, while MST for African American patients was 75 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;116:2437-47. (C) 2010 American Cancer Society