Researchers found significant relationships between the stage of cancer at initial presentation and various demographic and socioeconomic factors in a new study. The study’s findings were presented in a poster at the 2022 ASCO Annual Meeting.

Kiana Verplancke, BS, of the Creighton University School of Medicine and colleagues explained in their poster that cancer stage at initial presentation is a factor closely related to mortality risks in patients with lung cancer. The researchers undertook this study to identify factors that may be related to delays in diagnosis of non-small cell lung cancer (NSCLC).

The researchers identified patients for this study with a diagnosis of NSCLC from the National Cancer Database from the years of 2004 through 2018. The researchers considered 2 categories of cancer stages in multivariate analyses of various demographic and socioeconomic factors and cancer stage at diagnosis. For the purposes of this study, an early-stage diagnosis included stages 0 or I, and a delayed/advanced diagnosis included stage IV.

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The study included 1,772,978 patients diagnosed with NSCLC. Of these, 27.2% of patients had a stage 0 or I diagnosis at presentation, while 38% had a stage IV diagnosis. Analyses included 1,149,539 patients who had either stage 0-I or stage IV diagnoses.

Numerous factors appeared to be related to stage at diagnosis in multivariate analyses. Female patients were diagnosed with advanced cancer about 70% less often than male patients were (odds ratio [OR], 0.702; 95% CI, 0.697-0.708). Compared with White patients, both African American patients (OR, 1.428; 95% CI, 1.407-1.449) and American Indian patients (OR, 1.137; 95% CI, 1.046-1.235) were more likely to present with advanced disease. Hispanic patients were diagnosed with advanced disease significantly more often than non-Hispanic patients were (OR, 1.493; 95% CI, 1.389-1.605).

Additional factors that appeared related to stage of NSCLC diagnosis included the presence of comorbidities and the education level of patients’ residential zip codes. Having a Charlson Comorbidity Index score of 1, 2, 3, or higher was associated with a lower risk of being diagnosed with advanced disease, compared with a score of 0. Zip codes in which less than 29.0% of residents did not have a high school degree were associated with lower rates of advanced diagnosis. An advanced stage at initial presentation was also more likely among residents of the Midwest and the Western states of the United States, compared with Southern and Northeastern regions.

The research team concluded that particular demographic and socioeconomic factors appeared related to the stage of NSCLC during initial presentation. These results may support awareness of populations at risk of advanced NSCLC, the authors concluded.

Disclosures: Some authors have declared affiliations with or received grant support from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.


  1. Verplancke K, Taylor A, Gallegos JM, et al. Demographic and socioeconomic factors associated with stage at diagnosis in non-small cell lung cancer: an NCDB analysis. Presented at ASCO 2022; June 3-7, 2022. Abstract 9132.

This article originally appeared on Oncology Nurse Advisor