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Racial disparities and survival for nonsmall-cell lung cancer in a large cohort of black and white elderly patients

TitleRacial disparities and survival for nonsmall-cell lung cancer in a large cohort of black and white elderly patients
Publication TypeJournal Article
Year of Publication2009
AuthorsHardy, D, Xia, R, Liu, CC, Cormier, JN, Nurgalieva, Z, Du, XL
JournalCancerCancer
Volume115
Pagination4807-18
Date PublishedOct 15
ISBN Number0008-543X (Print)<br/>0008-543X (Linking)
Accession Number19626650
KeywordsAfrican Americans, Aged, Aged, 80 and Over, Carcinoma, Non-Small-Cell Lung/ ethnology/ mortality/therapy, European Continental Ancestry Group, Female, Health Status Disparities, Humans, Lung Neoplasms/ ethnology/ mortality/therapy, Male, Risk Factors, Survival Rate, Time Factors
AbstractBACKGROUND: This study aimed to examine disparities in survival and associated factors for patients with nonsmall-cell lung cancer (NSCLC) and to determine whether racial disparities varied over time (1991-1995, 1996-1999, and 2000-2002). METHODS: The authors studied 70,901 patients aged>or=65 years with stage I-IV NSCLC identified from Surveillance, Epidemiology, and End Results/Medicare data. Multivariate time-to-event survival analyses were completed using Cox proportional regression modeling. RESULTS: The 5-year observed lung cancer-specific survival rates were 52.7% for whites and 47.5% for blacks with stage I-II disease, and 17.7% and 19.6% for whites and blacks, respectively at stages III-IV. After controlling for standard treatment, socioeconomic status (SES), and other factors, there were no significant differences in all-cause mortality, or lung cancer-specific mortality between black and white patients with stage I-II or III-IV lung cancer. However, blacks had an increased risk for overall all-cause mortality at stage I-IV (hazard ratio [HR], 1.24; 95% confidence interval, 1.13-1.35), and during 2000-2002 at stage III-IV for all-cause mortality (HR, 1.22; 95% CI, 1.02-1.47) and lung cancer-specific mortality (HR, 1.24; 95% CI,1.01-1.53). Standard treatment was significantly associated with increased survival, whereas poor SES was associated with increased mortality. CONCLUSIONS: There were no significant differences in survival between blacks and whites with NSCLC within stage stratifications after adjusting for covariates, except for black patients at overall stage for all-cause mortality and at stage III-IV diagnosed in 2000-2002. Receiving stage-specific evidence-based standard therapy was associated with significantly increased survival.
Short TitleCancer
Ethno Med: