Financial Toxicity Among Topics Presented at AACR Conference

Multiple Factors Affect Lung Cancer Disparities

Lung cancer is the leading cause of cancer-related deaths than any other type of cancer.⁷ Disparities in lung cancer incidence and survival have been linked to geographic location of patients, socioeconomic status, and race.⁸

Brid M. Ryan, PhD, MPH, of the National Cancer Institute in Bethesda, MD, focused on the various biological, genetic, and environmental factors that contribute to disparities in lung cancer incidence and survival.⁹

Dr. Ryan noted that while African Americans have lower rates of smoking than European Americans, they have lung ademocarcinoma rates that are 1.30 times higher and squamous cell carcinoma rates that are 1.80 times higher than European Americans. She discussed a number of studies that have suggested environmental and genetic factors that may contribute to this disparity, and recommended continued research into these and other factors.

“Apart from smoking, there are other factors that contribute to lung cancer incidence, such as radon exposure, inflammatory conditions, and exposure to secondhand smoke,” wrote Dr. Ryan in an email to Cancer Therapy Advisor. “There is ongoing work to try and determine if these factors, or indeed other unknown factors, contribute to the higher incidence rate.”

Dr. Ryan pointed out that equal access to care may be a “key determinant” to reducing disparities in survival. “It is clear that when patients have equal access to care differences in outcomes can be reduced,” she wrote. “Ensuring equal access to care is a multi-factorial issue that involves the patient, the provider, clinical institution, and health insurance status. Practicing oncologists can play an important role, but it is important to study and remove barriers that may prevent the patient getting to meet an oncologist in the first place.”

References

1. National Cancer Institute. Cancer health disparities.  http://www.cancer.gov/research/areas/disparities. Accessed November 23, 2015.
2. DeLancey JO. Recent trends in black-white disparities in cancer mortality. Cancer Epidemiol Biomarkers Prev. 2008;17(11):2908-2912.
3. Zafar Y, Peppercorn J, Schrag D, et al. The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient’s experience. Oncologist. 2013;18(4):381-390.
4. de Souza J, Yap BJ, Hlubocky FJ, et al. The development of a financial toxicity patient-reported outcome in cancer: the COST measure. Cancer. 2014;120(20):3245-3253.
5. Shankaran V. Financial distress in patients with cancer: contributing factors and potential solutions. Oral presentation at: Eighth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; November 13-16, 2015; Atlanta, GA.
6. Zafar Y. Intervening on the financial toxicity of cancer care. Oral presentation at: Eighth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; November 13-16, 2015; Atlanta, GA.
7. Centers for Disease Control and Prevention. Lung cancer statistics. http://www.cdc.gov/cancer/lung/statistics/index.htm . Updated August 20, 2015. Accessed November 23, 2015.
8. Singh G, Williams SD, Siahpush M, Mulhollen A. Socioeconomic, rural-urban, and racial inequalities in US cancer mortality: part I—all cancers and lung cancer and part II—colorectal, prostate, breast, and cervical cancers. J Cancer Epidemiol. 2011;107497
9. Ryan B. Genetic, environmental, and biological contributions to racial disparities in lung cancer incidence. Oral presentation at: Eighth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; November 13-16, 2015; Atlanta, GA.