|The following article features coverage from the 2021 AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved. Click here to read more of Cancer Therapy Advisor’s conference coverage.|
Equal access to diagnostic services and immunotherapy could eliminate outcome disparities between Black and White patients with lung cancer, according to 2 new studies.
One study suggested that modifiable factors could improve racial disparities in the stage at which lung cancer is diagnosed.1 The second study suggested that equal access to immunotherapy mitigates racial disparities in survival for patients with advanced non-small cell lung cancer (NSCLC).2
Both studies were presented at the 2021 AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved.
Disparities in Stage at Diagnosis
More Black than White Americans are diagnosed with distant spread of lung cancer, said Jennifer Richmond, PhD, of Vanderbilt University in Nashville, Tennessee, during her presentation at the conference.1
Dr Richmond cited recent data suggesting that 61% of Black patients and 56% of White patients have distant-stage lung cancer at diagnosis.3
Because presentation at a late stage is associated with higher lung cancer-specific mortality and fewer treatment options, Dr Richmond and colleagues sought to determine the factors most responsible for racial disparities in stage at diagnosis.
The researchers analyzed data on roughly 85,000 patients in the Southern Community Cohort study. The patients were enrolled during 2002-2009 and followed through 2019. The cohort included 1466 lung cancer cases.
The investigators used logistic and multinomial regression models to identify factors predictive of distant stage at presentation. Individual-level factors (age at diagnosis, sex, and smoking status) and area-level factors (area deprivation status and distance from a comprehensive cancer center) were examined.
As expected, more Black patients than White patients were diagnosed with distant-stage lung cancer — 50% and 43%, respectively (odds ratio [OR], 1.34; 95% CI, 1.08-1.66).
However, after the researchers adjusted for clinical and area-level factors, the racial differences in stage at diagnosis disappeared (OR, 0.219; 95% CI, 0.03-1.54; P =.13).
The investigators also found that living farther from a comprehensive cancer center was associated with slightly higher odds of being diagnosed at a distant stage (OR, 1.001, 95% CI; 1.00-1.002; P =.03).
Dr Richmond concluded that, although more Black than White participants were diagnosed with distant-stage lung cancer, modifiable factors — such as access to comprehensive cancer centers — could improve racial disparities in stage at diagnosis.