Patients with small-cell lung cancer (SCLC) may have more socioeconomic disadvantages than those with non-small cell lung cancer (NSCLC), new research suggests.
These disadvantages likely contribute to the poor survival outcomes observed in SCLC, according to researchers. They presented these findings in a poster at the NCCN 2022 Annual Conference.
The researchers compared demographics and treatment characteristics between NSCLC and SCLC patients enrolled in the National Cancer Database between 2004 and 2016. The cohort included 1,903,720 patients overall — 1,641,671 diagnosed with NSCLC and 262,049 with SCLC.
Patients with NSCLC were less likely than those with SCLC to have 1 or more comorbidities — 40.59% and 44.71%, respectively (P <.0001).
On the other hand, patients with NSCLC were more likely than SCLC patients to:
- Live in metro areas — 79.77% vs 77.42% (P <.0001)
- Have private insurance — 27.25% vs 26.88% (P <.0001)
- Be treated at academic centers — 31.08% vs 26.25% (P <.0001)
- Have a higher education level (P <.0001).
The median overall survival (OS) was 17.48 months in the NSCLC group and 8.51 months in the SCLC group. The 5-year OS rates were 27.2% and 7.6%, respectively.
In both cohorts, better OS was significantly associated with having private insurance, receiving treatment at an academic center, and attaining a higher education level (P <.0001 for all).
“Patients with SCLC face more socioeconomic disadvantages as compared to patients with NSCLC; these may play a role in decreased survival, as they can impact access to health care facilities,” the researchers wrote.
“We feel strongly that focused health care outreach programs will lead to improved outcomes in these populations: improved telehealth resources, academic center outreach and affiliation with rural centers, access to primary care and CT screening, and smoking cessation efforts,” the researchers concluded.
Roof L, Wei W, Stevenson JP. Patient demographic and socioeconomic differences in non-small cell and small cell lung cancers: Impact on outcomes. Presented at NCCN 2022 Annual Conference; March 31 – April 2, 2022. Abstract HSR22-166.