Ethnicity, insurance status, and other factors are associated with overall survival (OS) in patients with non-small cell lung cancer (NSCLC), according to research presented at the International Association for the Study of Lung Cancer (IASLC) 18TH Annual World Conference on Lung Cancer (October 15-18, 2017; Yokohama, Japan).
Recent advancements in NSCLC treatment have shown to significantly improve survival outcomes. However, outcomes disparities still exist in this patient population, prompting the need for an investigation into factors that may influence such disparities.
Yanyan Lou, MD, PhD, Mayo Clinic (Rochester, MN), and colleagues conducted a retrospective study to evaluate survival and socioeconomic data for patients with NSCLC to identify particular factors that may predict OS. A total of 1,150,722 patients were sampled for the study, all of whom were diagnosed between 2004 and 2013.
Researchers noted that a majority of patients in the sample were Caucasian (86.4%), 10.6% were African-American, and less than 5% were either Hispanic or Asian. Additionally, almost 97% of patients were insured, 81.7% resided in a metropolitan area, and 68.5% received treatment at a non-academic facility.
Results of the study indicated numerous factors that may be associated with OS in NSCLC. Caucasian patients had a median OS of 13.2 months, African-American patients had a median OS of 11.5 months, Asian patients had a median OS of 18.2 months, and Hispanic patients had a median OS of 16.6 months. Diagnosis between 2010 and 2013 resulted in a longer median OS than a diagnosis between 2004 and 2009 (HR, 0.88). Those with tumor, node, and metastasis stage IV disease at diagnosis were significantly more likely to have a shorter OS compared with those diagnosed with stage I disease (HR, 5.60).
Furthermore, data supported links to shorter OS with a lack of insurance, higher Charlson-Deyo comorbidity score, lower income, and treatment at a non-academic facility.
"The study is the largest analysis on the correlation between race and socioeconomic factors and NSCLC outcomes to date," said Dr Lou in the presentation. "Our findings indicate that improving outcomes for NSCLC doesn't solely rely on advancements in medicine, but also on ensuring more equitable health care delivery.”—Zachary Bessette