No Racial Disparity in Survival Among Veterans With Early-stage NSCLC
Among U.S. veterans with early-stage non-small cell lung cancer, there appears to be no racial disparity in surgery, overall survival.
Editor's Note: The last sentence of the penultimate paragraph of a previous version of this article read: "...had a higher risk of death compared with white patients." This has been changed to "had a lower risk of death compared with white patients."
Among U.S. veterans with early-stage non-small cell lung cancer (NSCLC), there appears to be no racial disparity in surgery, overall survival, or lung cancer-specific survival in the equal access veteran affairs healthcare system, according to an article published in Journal of Thoracic Oncology.1
Previous research has demonstrated lower rates of surgery and poorer survival for African-American patients with early-stage NSCLC compared with white patients. Researchers examined treatment trends among these 2 groups of patients with early-stage NSCLC in an effort to evaluate the presence of racial disparities in survival.
Investigators retrospectively analyzed data from 18,466 patients in the Veteran Affairs Central Cancer Registry who were diagnosed with stage I-II NSCLC between 2001 and 2010. Patients were categorized as having received surgery, radiotherapy, other/no treatment.
The results showed a significant disparity in surgery rates between these patient groups, though the disparity decreased over time (P = .01). There were no observed significant racial differences in those treated with radiation.
Race was not found to be associated with overall survival among all patients (hazard ratio, 0.97; 95% CI, 0.93-1.02).
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Among patients who underwent surgery, there was no racial difference in overall survival (hazard ratio, 0.94; 95% CI, 0.87-1.01), but African-American patients who received radiation treatment (hazard ratio, 0.90; 95% CI, 0.82-0.98) or other/no treatment (hazard ratio, 0.89; 95% CI, 0.81-0.97) had a lower risk of death compared with white patients.
The study also demonstrated no association between race and lung cancer-specific survival among all patients or within each treatment category.
- Williams CD, Salama JK, Moghanaki, Karas TZ, Kelley MJ. Impact of race on treatment and survival among U.S. veterans with early-stage lung cancer [published online ahead of print June 10, 2016]. J Thorac Oncol. doi: 10.1016/j.jtho.2016.05.030.