Regional Variation in Treatment for Highest-Risk Patients With Non-Small Cell Lung Cancer

Katherine J. Bick, Li Ding, Peggy J. Ebner, Anthony W. Kim, Scott M. Atay, Sean C. Wightman, P. Michael McFadden, Albert J. Farias, Elizabeth A. David

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Non-small cell lung cancer patients with multiple high-risk socioeconomic factors experience treatment and survival disparities. We aim to assess whether disparities in treatment and survival vary by region for patients with 3 or more high-risk socioeconomic factors. Methods: The National Cancer Database was queried for patients with clinical stage I-IIA non-small cell lung cancer diagnosed between 2010 and 2015. Patients were categorized into 3 groups: standard treatment, nonstandard treatment, and no curative treatment. Multivariable logistic regression was used to evaluate regional differences in treatment. Cox proportional hazards regression and the Kaplan-Meier method were used for survival analysis. All statistical tests were 2-sided. Results: A total of 93,211 patients met inclusion criteria. For patients with 3 or more high-risk socioeconomic factors, the odds of nonstandard treatment were significantly greater in 6 regions compared with New England, greatest in West North Central (odds ratio 2.09, P < .001). The odds of no curative treatment were significantly greater in 7 regions compared with New England, greatest in West South Central (odds ratio 3.56, P < .001). West North Central was associated with the highest risk of all-cause mortality compared with New England (hazard ratio 1.10, P < .001), and Middle Atlantic was associated with the lowest (hazard ratio 0.86, P < .001). The 5-year overall survival was longest in Middle Atlantic (60.8%) and shortest in Mountain (36.8%). Conclusions: Patients with 3 or more high-risk socioeconomic factors experience treatment and survival disparities across the United States, though disparities are more pronounced in certain regions. Regional interventions may help mitigate disparities among highest risk non-small cell lung cancer patients.

Original languageEnglish (US)
Pages (from-to)1282-1290
Number of pages9
JournalAnnals of Thoracic Surgery
Volume113
Issue number4
DOIs
StatePublished - Apr 2022
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Regional Variation in Treatment for Highest-Risk Patients With Non-Small Cell Lung Cancer'. Together they form a unique fingerprint.

Cite this