Lung Cancer |

Racial Disparities in the Treatment of Nonsurgical Patients With Lung Cancer FREE TO VIEW

Srinadh Annangi, MBBS; Hari Prasad Ravipati, MD; Swathi Nutakki, MBBS; Eric Flenaugh, MD
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Division of Pulmonary and Critical Care Medicine, Morehouse School of Medicine, Atlanta, GA

Chest. 2014;145(3_MeetingAbstracts):323A. doi:10.1378/chest.1792413
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SESSION TITLE: Lung Cancer Posters II

SESSION TYPE: Poster Presentations

PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM

PURPOSE: Studies have shown racial disparities in the surgical rates for early stage Non-Small Cell Lung Cancer (NSCLC).We analyzed the National Surveillance Epidemiology and End Results (SEER) database to determine if racial disparities exist in reasons for not undergoing surgery and radiotherapy given to nonsurgical patients.

METHODS: Retrospective population-based cohort study was done using SEER 18 registries database. NSCLC cases staged as IA, IB, IIA and IIB and diagnosed between 2004 and 2010 were included. Non-surgical cases were analyzed for disparities between whites and blacks using SEER variables “reason no cancer directed surgery”, “radiation” and “CS tumor size”. Chi-square and Fishers exact tests were used for statistical analysis.

RESULTS: 6628 NSCLC cases were identified of which 4210 cases didn’t receive surgery. Blacks are less likely than whites to receive radiotherapy for stage IA NSCLC (p <0.05). Subgroup analysis of stage IA non-surgical cases where surgery was not recommended revealed significantly fewer blacks received radiotherapy (60.9% white vs 46.7% of black, p =0.006). No racial disparities were seen between patients receiving radiotherapy for stages IB, IIA and IIB (p >0.05). Proportion of tumors less than 2cm in size for stages IA, IIA and less than 5cm in size for stages IB, IIB showed no significant difference between the compared races (p >0.05). Proportion of blacks undergoing their recommended surgery was lower compared to whites for stages IA (85.8% vs 78.3, p <0.05) and IB (81.3% vs 74.6, p <0.05). There were no significant disparities with respect to reasons for not undergoing surgery being surgery not recommended and/or contraindicated (p >0.05).

CONCLUSIONS: Significant racial differences were present with respect to radiotherapy for non surgical cases with stage IA disease. No differences were noted with respect to tumor sizes for all stages. For stages IA and IB blacks are less likely to undergo their recommended surgery. Failure to recommend surgery is not accountable for lower surgical rates in blacks.

CLINICAL IMPLICATIONS: With radiotherapy being the important modality of treatment for non-surgical early stage NSCLC, eliminating the racial disparities in radiotherapy being given can improve survival in black population.

DISCLOSURE: The following authors have nothing to disclose: Srinadh Annangi, Hari Prasad Ravipati, Swathi Nutakki, Eric Flenaugh

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