Study examines racial disparities in survival among patients diagnosed with lung cancer

January 19, 2009

Disparities in survival among black patients diagnosed with early-stage lung cancer are not seen when patients are recommended appropriate treatment, according to a report in the January issue of Archives of Surgery, one of the JAMA/Archives journals.

Lung cancer causes more deaths in the United States than any other cancer, according to background information in the article. Pulmonary resection—or surgery to remove a portion of the lung—provides the best chance for patients with early-stage disease to be cured. "Black patients with early-stage lung cancer have lower five-year survival rates than white patients, and this difference in outcome has been attributed to lower rates of resection among black patients," the authors write.

"Several potential factors underlying racial differences in the receipt of surgical therapy include differences in pulmonary function, access to care, refusal of surgery, beliefs about tumor spread on air exposure at the time of operation and the possibility of cure without surgery, distrust of the health care system and physicians, suboptimal patterns of patient and physician communication and health care system and provider biases." Of these, access to care is often considered the most important of factors underlying racial disparities.

Farhood Farjah, M.D., M.P.H., of the University of Washington, Seattle, and colleagues designed a study to address whether differences in survival persist when evaluating only patients who had been recommended to receive optimal therapy, in this case lung resection. Patients recommended for therapy were considered likely to have "cleared" at least one major hurdle of access to care. The investigators analyzed data from 17,739 patients who were diagnosed with lung cancer between 1992 and 2002 (average age 75, 89 percent white and 6 percent black) and who were recommended to receive surgical therapy. They tracked whether or not the patients underwent surgery, and their overall survival, through 2005.

While black patients recommended to surgery had lung resections less frequently than white patients (69 percent vs. 83 percent, the authors write. After adjustment, there was no significant association between race and death.

Several possible explanations exist for the differences in rates of surgery, the authors note, and these may be important for understanding patient decision-making and improving care delivery systems. Black patients may be more likely to refuse surgery than white patients, or may have more limited access to recommended care.

Paper: Arch Surg. 2009;144[1]:14-18.

Source: JAMA and Archives Journals

Explore further: Cancer in context: 37 years of painstakingly collected data

Related Stories

Cancer in context: 37 years of painstakingly collected data

August 15, 2016

Prostate and lung cancer have been the No. 1 and 2 cancers among men. Stomach cancer, the third leading cause of cancer deaths worldwide, has been on a steady decline among Koreans and Japanese. Black men had the highest ...

3-D virtual reality colonoscopy

July 6, 2016

At UCSF's 3-D Imaging Lab, radiologist Judy Yee, MD, pulls up an image that looks more like a birthday party balloon animal than a patient's colon: a vibrant, color-segmented tube, torqued and twisted in on itself.

Recommended for you

How the finch changes its tune

August 3, 2015

Like top musicians, songbirds train from a young age to weed out errors and trim variability from their songs, ultimately becoming consistent and reliable performers. But as with human musicians, even the best are not machines. ...

Cow embryos reveal new type of chromosome chimera

May 27, 2016

I've often wondered what happens between the time an egg is fertilized and the time the ball of cells that it becomes nestles into the uterine lining. It's a period that we know very little about, a black box of developmental ...

Shaving time to test antidotes for nerve agents

February 29, 2016

Imagine you wanted to know how much energy it took to bike up a mountain, but couldn't finish the ride to the peak yourself. So, to get the total energy required, you and a team of friends strap energy meters to your bikes ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.