IASLC 2017: Race, Socioeconomic Factors Are Influential in NSCLC Survival Rates

Key Points

  • Median overall survival was significantly better for Asians and Hispanics as compared to whites and blacks. The range of medians between the highest (Asian) and lowest (black) overall survival rates was over half a year (6.7 months).
  • Outcomes were worse when there was a higher rate of comorbidity with other diseases, advanced stage of cancer, and treatment at a community or low-volume center.
  • Specific socioeconomic factors were associated with worse outcomes, including lower education levels, lower median income, and uninsured status.

New research found race and specific socioeconomic factors to have a significant influence on disparities in the survival rates of non–small cell lung cancer (NSCLC) patients. Yanyan Lou, MD, PhD, of the Mayo Clinic, presented these findings at the International Association for the Study of Lung Cancer (IASLC) 18th World Conference on Lung Cancer (WCLC) in Yokohama, Japan.

While NSCLC patient outcomes have improved over time, the influence of race and socioeconomic factors on these outcomes has historically not been well studied. By using data from the National Cancer Database on NSCLC incident cases from 2004–2013 in the United States, Dr. Lou and her team sought to determine whether a correlation exists between patients' overall survival and various socioeconomic factors and race.

Of the more than 1.1 million cases studied, 86.4% of patients were white, 10.6% were black, and smaller proportions were Asian and Hispanic. Income was fairly evenly distributed. Additionally, a majority of the cases were individuals who were insured, lived in a metropolitan area, and received care at nonacademic facilities.

Findings

The researchers found that the median overall survival was significantly better for Asians and Hispanics as compared to whites and blacks. The range of medians between the highest (Asian) and lowest (black) overall survival rates was over half a year (6.7 months). Additionally, they found that outcomes were worse when there was a higher rate of comorbidity with other diseases, advanced stage of cancer, and treatment at a community or low-volume center. Finally, the researchers determined that specific socioeconomic factors were associated with worse outcomes, including lower education levels, lower median income, and uninsured status.

Based on this study, the researchers determined that the influence of race and specific socioeconomic factors is significant. In order to ensure fair treatment and patient outcomes, these factors must be considered in the provision of care for NSCLC.

“The study is the largest analysis on the correlation between race and socioeconomic factors and NSCLC outcomes to date,” said Dr. Lou. “Our findings indicate that improving outcomes for NSCLC patients doesn't solely rely on advancements in medicine, but also on ensuring more equitable health-care delivery.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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