Survival Advantage Seen in Foreign-Born Hispanics With NSCLC
Foreign-born Hispanics with non–small cell lung cancer (NSCLC) have a decreased risk of disease-specific mortality compared with non-Hispanic whites and United States-born Hispanics with NSCLC, according to a study published in the Journal of Clinical Oncology. Manali I. Patel, MD, and colleagues from Stanford University, conducted a retrospective analysis of data from 1996 to 2007 (with a follow-up through 2009) from the California Cancer Registry of non-Hispanic whites and 14,280 Hispanics with NSCLC to assess individual (age, sex, marital status), clinical (histologic grade, surgery, radiation, chemotherapy), and neighborhood factors (neighborhood socioeconomic status, ethnic enclave) in survival.
Study Findings
The researchers found that foreign-born Hispanics had a 15% decreased risk of disease-specific mortality resulting from NSCLC compared with non-Hispanic whites (hazard ratio [HR] = 0.85) after adjustment for individual, clinical, and neighborhood factors. After adjustment for individual factors, compared with U.S.–born Hispanics, foreign-born Hispanics had a 10% decreased risk of disease-specific mortality (HR = 0.90). Clinical and neighborhood factors slightly moderated the survival benefit for foreign-born patients.
A slightly greater survival advantage was seen for foreign-born Hispanics living in low socioeconomic and high Hispanic enclave neighborhoods compared with U.S.-born Hispanics (HR = 0.86).
“In conclusion, despite advanced stage at diagnosis, lower likelihood of treatment, and greater likelihood of living in low socioeconomic status neighborhoods, foreign-born Hispanics had improved survival after NSCLC than U.S.-born Hispanics and [non-Hispanic whites],” wrote the researchers. “The survival benefit among foreign-born Hispanics was slightly more pronounced among patients in low [socioeconomic status] and high-enclave neighborhoods.”
Further research focusing on specific attributes of foreign-born populations, especially those living in lower socioeconomic status and high-enclave neighborhoods, may help clarify the reasons for the paradox and help improve outcomes in NSCLC, the researchers concluded.
The researchers reported no potential conflicts of interest. This research was supported by a Stanford Cancer Institute Developmental Cancer Research Award.
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