Racial/ethnic disparities in curative‐intent treatment for early‐stage non‐small cell lung cancer patients among heterogeneous Black populations: US‐born Black, Afro‐Haitian, West Indian Black, and Hispanic Black
Abstract Background Heterogeneous Black populations encounter significant obstacles in accessing cancer care, yet research on lung cancer treatment disparities remains limited. This study investigates whether the disparity in receiving curative‐intent treatment (curative‐intent surgery and/or stereo...
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Wiley
2024-10-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.7449 |
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| author | Kamaria T. Jacobs Qinran Liu Clyde P. Brown Gilberto Lopes Paulo S. Pinheiro |
| author_facet | Kamaria T. Jacobs Qinran Liu Clyde P. Brown Gilberto Lopes Paulo S. Pinheiro |
| author_sort | Kamaria T. Jacobs |
| collection | DOAJ |
| description | Abstract Background Heterogeneous Black populations encounter significant obstacles in accessing cancer care, yet research on lung cancer treatment disparities remains limited. This study investigates whether the disparity in receiving curative‐intent treatment (curative‐intent surgery and/or stereotactic body radiation therapy [SBRT]) for early‐stage non‐small cell lung cancer (NSCLC) between non‐Hispanic Whites (NHWs) and total Blacks extends to diverse Black populations, including US‐born, Afro‐Haitian, West Indian Black, and Hispanic Black individuals. Methods This cross‐sectional study included all Florida cancer registry early‐stage NSCLC cases 2005–2017, linked to individual‐level discharge data containing comorbidity and specific treatment details (surgery and/or SBRT). Multivariable logistic regression assessed the association between race/ethnicity and the receipt of curative‐intent treatment, while accounting for sociodemographic factors (poverty, age, insurance, and smoking status) and clinical variables. Results Among 55,655 early‐stage NSCLC patients, 71.1% received curative‐intent treatment: 72.1% NHW and 59.7% Black (non‐Hispanic and Hispanic) individuals. Black patients had 35% lower odds (ORadj, 0.65; 95% CI, 0.59–0.70) of receiving curative‐intent treatment compared to NHW patients. ORs varied from 0.57 (95% CI, 0.59–0.70) for Hispanic Black to 0.76 (95% CI, 0.56–1.02) for West Indian Black. Remarkably, Black‐White disparities persisted despite the availability of curative treatment options (SBRT) for both high Charlson Comorbidity Index (CCI) observed among US‐born Blacks and surgery for low CCI patients among all other Black subgroups. Conclusions Pronounced disparities in accessing curative‐intent treatments for early‐stage NSCLC were evident across all Black subgroups, regardless of treatment availability and comorbidity profile. These findings underscore the need to address Black heterogeneity and prompt further research to rectify treatment disparities in early‐stage NSCLC. |
| format | Article |
| id | doaj-art-d3777d9708ca46fd9e989e2352d04584 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-d3777d9708ca46fd9e989e2352d045842025-08-20T03:47:24ZengWileyCancer Medicine2045-76342024-10-011319n/an/a10.1002/cam4.7449Racial/ethnic disparities in curative‐intent treatment for early‐stage non‐small cell lung cancer patients among heterogeneous Black populations: US‐born Black, Afro‐Haitian, West Indian Black, and Hispanic BlackKamaria T. Jacobs0Qinran Liu1Clyde P. Brown2Gilberto Lopes3Paulo S. Pinheiro4College of Pharmacy and Pharmaceutical Sciences, Institute of Public Health Florida A&M University Tallahassee Florida USADepartment of Public Health Sciences University of Miami School of Medicine Miami Florida USACollege of Pharmacy and Pharmaceutical Sciences, Institute of Public Health Florida A&M University Tallahassee Florida USASylvester Comprehensive Cancer Center University of Miami Miami Florida USADepartment of Public Health Sciences University of Miami School of Medicine Miami Florida USAAbstract Background Heterogeneous Black populations encounter significant obstacles in accessing cancer care, yet research on lung cancer treatment disparities remains limited. This study investigates whether the disparity in receiving curative‐intent treatment (curative‐intent surgery and/or stereotactic body radiation therapy [SBRT]) for early‐stage non‐small cell lung cancer (NSCLC) between non‐Hispanic Whites (NHWs) and total Blacks extends to diverse Black populations, including US‐born, Afro‐Haitian, West Indian Black, and Hispanic Black individuals. Methods This cross‐sectional study included all Florida cancer registry early‐stage NSCLC cases 2005–2017, linked to individual‐level discharge data containing comorbidity and specific treatment details (surgery and/or SBRT). Multivariable logistic regression assessed the association between race/ethnicity and the receipt of curative‐intent treatment, while accounting for sociodemographic factors (poverty, age, insurance, and smoking status) and clinical variables. Results Among 55,655 early‐stage NSCLC patients, 71.1% received curative‐intent treatment: 72.1% NHW and 59.7% Black (non‐Hispanic and Hispanic) individuals. Black patients had 35% lower odds (ORadj, 0.65; 95% CI, 0.59–0.70) of receiving curative‐intent treatment compared to NHW patients. ORs varied from 0.57 (95% CI, 0.59–0.70) for Hispanic Black to 0.76 (95% CI, 0.56–1.02) for West Indian Black. Remarkably, Black‐White disparities persisted despite the availability of curative treatment options (SBRT) for both high Charlson Comorbidity Index (CCI) observed among US‐born Blacks and surgery for low CCI patients among all other Black subgroups. Conclusions Pronounced disparities in accessing curative‐intent treatments for early‐stage NSCLC were evident across all Black subgroups, regardless of treatment availability and comorbidity profile. These findings underscore the need to address Black heterogeneity and prompt further research to rectify treatment disparities in early‐stage NSCLC.https://doi.org/10.1002/cam4.7449African AmericanBlack HispanicsBlack subgroupsComorbiditiesCurative‐intent treatmentHaitians |
| spellingShingle | Kamaria T. Jacobs Qinran Liu Clyde P. Brown Gilberto Lopes Paulo S. Pinheiro Racial/ethnic disparities in curative‐intent treatment for early‐stage non‐small cell lung cancer patients among heterogeneous Black populations: US‐born Black, Afro‐Haitian, West Indian Black, and Hispanic Black Cancer Medicine African American Black Hispanics Black subgroups Comorbidities Curative‐intent treatment Haitians |
| title | Racial/ethnic disparities in curative‐intent treatment for early‐stage non‐small cell lung cancer patients among heterogeneous Black populations: US‐born Black, Afro‐Haitian, West Indian Black, and Hispanic Black |
| title_full | Racial/ethnic disparities in curative‐intent treatment for early‐stage non‐small cell lung cancer patients among heterogeneous Black populations: US‐born Black, Afro‐Haitian, West Indian Black, and Hispanic Black |
| title_fullStr | Racial/ethnic disparities in curative‐intent treatment for early‐stage non‐small cell lung cancer patients among heterogeneous Black populations: US‐born Black, Afro‐Haitian, West Indian Black, and Hispanic Black |
| title_full_unstemmed | Racial/ethnic disparities in curative‐intent treatment for early‐stage non‐small cell lung cancer patients among heterogeneous Black populations: US‐born Black, Afro‐Haitian, West Indian Black, and Hispanic Black |
| title_short | Racial/ethnic disparities in curative‐intent treatment for early‐stage non‐small cell lung cancer patients among heterogeneous Black populations: US‐born Black, Afro‐Haitian, West Indian Black, and Hispanic Black |
| title_sort | racial ethnic disparities in curative intent treatment for early stage non small cell lung cancer patients among heterogeneous black populations us born black afro haitian west indian black and hispanic black |
| topic | African American Black Hispanics Black subgroups Comorbidities Curative‐intent treatment Haitians |
| url | https://doi.org/10.1002/cam4.7449 |
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