Equal Access to Care Diminishes Racial Disparities in Lung Cancer Survival

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(ChemotherapyAdvisor) – Persisting racial disparities in lung cancer survival among civilian Americans are not evident in patients receiving care in the U.S. Military Health System, an equal-access healthcare program, according to research at the US Military Cancer Institute in Bethesda, MD and Walter Reed Institute of Research in Silver Spring, MD.
“Lung cancer is the leading cause of cancer-related death among men and women in the United States,” the authors report. An estimated 160,340 Americans will die of lung cancer in 2012. Particularly among men, US racial disparities in mortality persist, with an annual lung cancer mortality rate of 85.4 per 100,000 among black men and 66.9 per 100,000 among white men – a 28% excess.
Hypothesizing that higher mortality rates among black lung cancer patients is partly due to racial inequities in access to healthcare and timely early-stage cancer detection, Li Zheng, PhD, of the Military Cancer Institute's Epidemiology Program and colleagues compared outcomes for 1,027 black and 9,154 white military personnel from the Pentagon's Automated Central Tumor Registry (ACTUR) with civilian rates in the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER-9) database.
Outcome data from small-cell, non-small cell, squamous cell carcinoma, and adenocarcinoma lung cancer cases were analyzed using Kaplan-Meier survival curve and Cox proportional hazards regression models, stratified by tumor histology.  
“No racial differences in survival were observed” within the military population, the authors concluded.
In the military population, black and white survival rates were not significantly different for non-small cell, adenocarcinoma, and squamous cell carcinoma lung cancers, they reported. Overall 5-year survival rates were better in the MHS than in the general US population (p<0.01 in all cases except among white SCLC patients, for which the 2-tailed p = 0.09), the authors wrote.

There were not significant differences in tumor grade or stage data for black and white patients in this study.


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