Race, Insurance And Type of Hospital Define Lung Cancer Care Quality

Race, Insurance And Type of Hospital Define Lung Cancer Care Quality

shutterstock_168812945Researchers found that treatment of early stage non-small cell lung cancer is less available to those who are African Americans, Hispanics, and to those seeking treatment from a community hospital. The study entitled “Disparities in Treatment of Patients with Inoperable Stage I Non-Small Cell Lung Cancer: A Population-Based Analysis” was published this month in the Journal of Thoracic Oncology.

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Evidence shows that treatment during stage I of lung cancer is related with a higher long-term survival rate since the tumor has not yet spread to the lymph nodes. At present time, available treatments include surgery (although some patients may be inoperable due to complicating medical conditions), conventional radiotherapy (ConvRT), stereotactic body radiotherapy (SBRT), or no treatment (NoTx).

The team of researchers led by Dr. Matthew Koshy, a physician in the Department of Radiation Oncology at the University of Illinois at Chicago College of Medicine, examined patterns of care and discrepancies in receiving conventional radiotherapy, stereotactic body radiotherapy or no treatment in 39.822 patients (via National Cancer Database from 2003-2011) with inoperable stage I non-small cell lung cancer (NSCLC).

Data analysis using logistic regression was performed to examine potential predictors of receiving any radiation vs. NoTx and for receiving SBRT vs. ConvRT. Results revealed that, compared to caucasians, those who were black and hispanic were less probable to receive treatment with radiation. Moreover, results showed that treatment with BRT vs. ConvRT was more likely to be offered at an academic research program and a high-volume facility compared with a community cancer programs or low-volume facilities. In terms of treatments offered, researchers found that 25% SBRT, 28% ConvRT and 46% NoTx were received at academic centers campared to  68%, 11% and 21% , respectively, that were received in community hospitals.

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These findings have shown significant institutional and socioeconomic discrepancies in the treatment of inoperable stage I NSCLC, with the team of researchers indicating that the removal of obstacles to receive radiation therapy and improve access to SBRT may have important implications for survival in patients suffering with lung cancer.

In a press release Dr. Koshy commented, “We found significant disparities for treatment of a curable cancer based on race, insurance status, and whether or not treatment was at an academic or community hospital.”

“Reducing these disparities could lead to significant improvements in survival for many people with inoperable early stage lung cancer”, Dr. Koshy added, mentioning the possible clinical outcomes.

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