A new study has revealed significant racial disparities in how quickly minority patients with non–small cell lung cancer receive radiation therapy compared with their White counterparts, according to findings published by Rekulapelli et al in Health Equity.

Researchers reviewed data from more than 222,700 patients with non–small cell lung cancer across the country, and found that the mean time to radiation initiation was 61.7 days. When broken into groups depending on race, the mean time was 60.9 days for White patients, 65.9 days for Black patients, and 71.9 days for Asian patients.

These differences can have real consequences, since speedy treatment initiation may contribute to better outcomes. A single-week delay in treatment has been associated with a 3.2% and 1.6% increase in the risk of death for patients with stage I and stage II non–small cell lung cancer, respectively.

These troubling findings prompted the researchers to call for further investigations into the underlying causes of the disparities and to urge efforts to ensure equity in treatment access.

“Our results suggest that non-White [patients with] lung cancer have delayed time to cancer treatment compared with White patients, and this is not limited to a particular type of treatment facility," said senior study researcher Rajesh Balkrishnan, PhD, Full Professor of Public Health in the Department of Public Health Sciences at the University of Virginia School of Medicine and a member of the Cancer Population Health Sciences Program at the University of Virginia Cancer Center. “Collaboration among providers, community stakeholders, and organizations is much needed to increase accessibility and patient knowledge of cancer, and to overcome existing disparities in timely care for [patients with] lung cancer."

Potential Causes of Treatment Disparities

The researchers said there may be multiple reasons for the racial disparities. They noted that non-White patients were more likely to be uninsured, faced greater socioeconomic barriers to care, and may have been perceived by doctors as being at risk for not following through with their treatment plans. In addition, minority patients were more likely to report less satisfaction with their encounters with care providers.

The longest waits for treatment initiation were at academic health systems, the researchers reported. They suggested this may have been because patients began their treatment in community hospitals and other local facilities before they needed to be transferred to academic facilities that offered more complex care.

However, racial disparities were found across all types of hospitals, where White patients consistently had the shortest time to treatment, while Asian patients had the longest.

“These findings shed light on the potential presence … and impact of structural racism on patients seeking cancer treatment,” said Dr. Balkrishnan and his colleagues. “Further investigation into the societal determinants that perpetuate disparity in time to radiation therapy, and potential interventions in the clinical setting to improve cultural and racial sensitivity among health-care professionals, is recommended.”

Disclosure: For full disclosures of the study authors, visit liebertpub.com.