Racial disparities and treatment trends in a large cohort of elderly black and white patients with nonsmall cell lung cancer

Dale Sharon Hardy, Chih Chin Liu, Rui Xia, Janice N. Cormier, Wenyaw Chan, Arica White, Keith Burau, Xianglin L. Du

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Abstract

BACKGROUND: This study investigated whether there was a significant gap in receipt of treatment for nonsmall cell lung cancer (NSCLC) between blacks and whites, and whether the gap or disparity changed during the past 12 years from 1991 to 2002. METHODS: The study population consisted of 83,101 patients including 75,141 (90.4%) whites and 7960 (9.6%) blacks aged ≥65 years who were diagnosed with American Joint Committee on Cancer (AJCC) stages I-IV NSCLC identified from the Surveillance, Epidemiology, and End Results (SEER) program's Medicare database. Age-adjusted and sex-adjusted rates and crude and adjusted odds ratios for receiving appropriate stage-specific treatment of NSCLC were reported. RESULTS: For stages I-II NSCLC combined, blacks were 37% less likely (OR, 0.63; 95% confidence interval [CI], 0.55-0.73) to receive surgery, 42% less likely (OR, 0.58; 95% CI, 0.36-0.92) to receive chemotherapy, and for stages III-IV combined, 57% less likely (OR, 0.43; 95% CI, 0.30-0.61) to receive chemotherapy compared with whites. Older patients, women, and those in lower socioeconomic quartiles had greater disparities in receipt of treatment compared with the highest income quartile. Disparity trends were not significantly narrowed during the past 12 years between blacks and whites for receipt of the above treatments. CONCLUSIONS: There have been substantial disparities in receiving recommended treatments between blacks and whites, and these disparities have been relatively stable without a significant trend of narrowing during the past 12 years. Efforts should focus on providing appropriate quality treatment and educating blacks on the value of having these treatments to reduce these disparities in receipt of treatment for NSCLC.

Original languageEnglish (US)
Pages (from-to)2199-2211
Number of pages13
JournalCancer
Volume115
Issue number10
DOIs
StatePublished - May 15 2009

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Non-Small Cell Lung Carcinoma
Confidence Intervals
Therapeutics
SEER Program
Drug Therapy
hydroquinone
Medicare
Odds Ratio
Databases
Population
Neoplasms

Keywords

  • Disparity
  • Nonsmall cell lung cancer
  • Race/ethnicity
  • Time trends
  • Treatment

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Hardy, D. S., Liu, C. C., Xia, R., Cormier, J. N., Chan, W., White, A., ... Du, X. L. (2009). Racial disparities and treatment trends in a large cohort of elderly black and white patients with nonsmall cell lung cancer. Cancer, 115(10), 2199-2211. https://doi.org/10.1002/cncr.24248

Racial disparities and treatment trends in a large cohort of elderly black and white patients with nonsmall cell lung cancer. / Hardy, Dale Sharon; Liu, Chih Chin; Xia, Rui; Cormier, Janice N.; Chan, Wenyaw; White, Arica; Burau, Keith; Du, Xianglin L.

In: Cancer, Vol. 115, No. 10, 15.05.2009, p. 2199-2211.

Research output: Contribution to journalArticle

Hardy, DS, Liu, CC, Xia, R, Cormier, JN, Chan, W, White, A, Burau, K & Du, XL 2009, 'Racial disparities and treatment trends in a large cohort of elderly black and white patients with nonsmall cell lung cancer', Cancer, vol. 115, no. 10, pp. 2199-2211. https://doi.org/10.1002/cncr.24248
Hardy, Dale Sharon ; Liu, Chih Chin ; Xia, Rui ; Cormier, Janice N. ; Chan, Wenyaw ; White, Arica ; Burau, Keith ; Du, Xianglin L. / Racial disparities and treatment trends in a large cohort of elderly black and white patients with nonsmall cell lung cancer. In: Cancer. 2009 ; Vol. 115, No. 10. pp. 2199-2211.
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abstract = "BACKGROUND: This study investigated whether there was a significant gap in receipt of treatment for nonsmall cell lung cancer (NSCLC) between blacks and whites, and whether the gap or disparity changed during the past 12 years from 1991 to 2002. METHODS: The study population consisted of 83,101 patients including 75,141 (90.4{\%}) whites and 7960 (9.6{\%}) blacks aged ≥65 years who were diagnosed with American Joint Committee on Cancer (AJCC) stages I-IV NSCLC identified from the Surveillance, Epidemiology, and End Results (SEER) program's Medicare database. Age-adjusted and sex-adjusted rates and crude and adjusted odds ratios for receiving appropriate stage-specific treatment of NSCLC were reported. RESULTS: For stages I-II NSCLC combined, blacks were 37{\%} less likely (OR, 0.63; 95{\%} confidence interval [CI], 0.55-0.73) to receive surgery, 42{\%} less likely (OR, 0.58; 95{\%} CI, 0.36-0.92) to receive chemotherapy, and for stages III-IV combined, 57{\%} less likely (OR, 0.43; 95{\%} CI, 0.30-0.61) to receive chemotherapy compared with whites. Older patients, women, and those in lower socioeconomic quartiles had greater disparities in receipt of treatment compared with the highest income quartile. Disparity trends were not significantly narrowed during the past 12 years between blacks and whites for receipt of the above treatments. CONCLUSIONS: There have been substantial disparities in receiving recommended treatments between blacks and whites, and these disparities have been relatively stable without a significant trend of narrowing during the past 12 years. Efforts should focus on providing appropriate quality treatment and educating blacks on the value of having these treatments to reduce these disparities in receipt of treatment for NSCLC.",
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AU - Liu, Chih Chin

AU - Xia, Rui

AU - Cormier, Janice N.

AU - Chan, Wenyaw

AU - White, Arica

AU - Burau, Keith

AU - Du, Xianglin L.

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N2 - BACKGROUND: This study investigated whether there was a significant gap in receipt of treatment for nonsmall cell lung cancer (NSCLC) between blacks and whites, and whether the gap or disparity changed during the past 12 years from 1991 to 2002. METHODS: The study population consisted of 83,101 patients including 75,141 (90.4%) whites and 7960 (9.6%) blacks aged ≥65 years who were diagnosed with American Joint Committee on Cancer (AJCC) stages I-IV NSCLC identified from the Surveillance, Epidemiology, and End Results (SEER) program's Medicare database. Age-adjusted and sex-adjusted rates and crude and adjusted odds ratios for receiving appropriate stage-specific treatment of NSCLC were reported. RESULTS: For stages I-II NSCLC combined, blacks were 37% less likely (OR, 0.63; 95% confidence interval [CI], 0.55-0.73) to receive surgery, 42% less likely (OR, 0.58; 95% CI, 0.36-0.92) to receive chemotherapy, and for stages III-IV combined, 57% less likely (OR, 0.43; 95% CI, 0.30-0.61) to receive chemotherapy compared with whites. Older patients, women, and those in lower socioeconomic quartiles had greater disparities in receipt of treatment compared with the highest income quartile. Disparity trends were not significantly narrowed during the past 12 years between blacks and whites for receipt of the above treatments. CONCLUSIONS: There have been substantial disparities in receiving recommended treatments between blacks and whites, and these disparities have been relatively stable without a significant trend of narrowing during the past 12 years. Efforts should focus on providing appropriate quality treatment and educating blacks on the value of having these treatments to reduce these disparities in receipt of treatment for NSCLC.

AB - BACKGROUND: This study investigated whether there was a significant gap in receipt of treatment for nonsmall cell lung cancer (NSCLC) between blacks and whites, and whether the gap or disparity changed during the past 12 years from 1991 to 2002. METHODS: The study population consisted of 83,101 patients including 75,141 (90.4%) whites and 7960 (9.6%) blacks aged ≥65 years who were diagnosed with American Joint Committee on Cancer (AJCC) stages I-IV NSCLC identified from the Surveillance, Epidemiology, and End Results (SEER) program's Medicare database. Age-adjusted and sex-adjusted rates and crude and adjusted odds ratios for receiving appropriate stage-specific treatment of NSCLC were reported. RESULTS: For stages I-II NSCLC combined, blacks were 37% less likely (OR, 0.63; 95% confidence interval [CI], 0.55-0.73) to receive surgery, 42% less likely (OR, 0.58; 95% CI, 0.36-0.92) to receive chemotherapy, and for stages III-IV combined, 57% less likely (OR, 0.43; 95% CI, 0.30-0.61) to receive chemotherapy compared with whites. Older patients, women, and those in lower socioeconomic quartiles had greater disparities in receipt of treatment compared with the highest income quartile. Disparity trends were not significantly narrowed during the past 12 years between blacks and whites for receipt of the above treatments. CONCLUSIONS: There have been substantial disparities in receiving recommended treatments between blacks and whites, and these disparities have been relatively stable without a significant trend of narrowing during the past 12 years. Efforts should focus on providing appropriate quality treatment and educating blacks on the value of having these treatments to reduce these disparities in receipt of treatment for NSCLC.

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KW - Race/ethnicity

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