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Disparities in Early Stage of Lung Cancer Treatment According to Hispanic Origin A Population-Based Study
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A5984 - Disparities in Early Stage of Lung Cancer Treatment According to Hispanic Origin A Population-Based Study
Author Block: M. P. Zambrano Loor1, J. P. Wisnivesky2, G. Mhango3, F. Fernandes4, N. J. Ferreras5; 1Universidad de Guayaquil Facultad de Ciencias Medicas, Guayaquil, Ecuador, 2Mt Sinai Medical Center, New York City, NY, United States, 3Mount Sinai Medical Center, New York City, NY, United States, 4Hospital das Clinicas da Faculdade de Medicina, SÃO PAULO - SP, Brazil, 5Liberty Harbour Medical Group, Jersey City, NJ, United States.
Background: Nationally representative data demonstrated lower resection rates and poorer long-term outcomes among Hispanics with lung cancer. However, Hispanics in the United States are a heterogeneous population, including Mexicans, Puerto Rican, and other central and South American ethnicities. These groups have varied risk of lung cancer and different cultural beliefs about cancer and lung surgery, potentially leading to different treatment patterns. However, prior studies have not investigated lung cancer treatment patterns in Hispanic subgroups.
Methods: The study was conducted using the Surveillance, Epidemiology, and End Result program. We included 100,173 patients with histologically confirmed primary stage I-II non-small cell lung cancer (NSCLC) diagnosed between 2004 and 2013. Patients were classified into non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, American Indian and Pacific Islander, or Hispanic. Furthermore, Hispanic patients were further categorized based on their origin into: Mexicans, Puerto Ricans, Cubans and Central or South Americans. Unadjusted odds ratios (OR) and nominal regression analyses were used to assess the adjusted relationship between Hispanic subgroups and treatment (surgery, radiation, or no treatment) while controlling for age, sex, marital status, year of diagnosis, cancer stage, tumor size, histology and tumor site.
Results: Unadjusted analysis showed that Mexicans (OR: 0.61, 95% CI: 0.50-0.56), Cubans (OR: 0.40, 95% CI: 0.27-0.59), and South and Central Americans (OR: 0.80, 95% CI: 0.59-1.07) were less likely to undergo surgery compared to non-Hispanic whites. No significant differences resection rates were observed for other Hispanic subgroups. Mexicans (OR: 0.78, 95% CI: 0.65-0.94), Cubans (OR: 0.52, 95% CI: 0.33-0.82), and South and Central Americans (OR: 0.85, 95% CI: 0.61-1.19) were also less likely to undergo radiation compared to non-Hispanic whites. Adjusted analyses also showed lower rates of treatments among Mexicans (OR: 0.78, 95% CI: 0.64-0.97 and OR: 0.72, 95% CI: 0.57-0.90 for surgery and radiation, respectively) and Cubans (OR: 0.31, 95% CI: 0.19-0.50 and OR: 0.4795% CI: 0.28-0.79 for surgery and radiation, respectively) compared to non-Hispanic whites, but not Puerto Ricans or Hispanics from South or Central America.
Conclusions: We found considerable heterogeneity in disparities in lung cancer care among different Hispanic subgroups living in the United States with Mexicans and Cubans having the lower odds of treatment for early stage NSCLC. Additional research into the factors underlying these differences in treatment is needed to address these important gaps in care.
Author Block: M. P. Zambrano Loor1, J. P. Wisnivesky2, G. Mhango3, F. Fernandes4, N. J. Ferreras5; 1Universidad de Guayaquil Facultad de Ciencias Medicas, Guayaquil, Ecuador, 2Mt Sinai Medical Center, New York City, NY, United States, 3Mount Sinai Medical Center, New York City, NY, United States, 4Hospital das Clinicas da Faculdade de Medicina, SÃO PAULO - SP, Brazil, 5Liberty Harbour Medical Group, Jersey City, NJ, United States.
Background: Nationally representative data demonstrated lower resection rates and poorer long-term outcomes among Hispanics with lung cancer. However, Hispanics in the United States are a heterogeneous population, including Mexicans, Puerto Rican, and other central and South American ethnicities. These groups have varied risk of lung cancer and different cultural beliefs about cancer and lung surgery, potentially leading to different treatment patterns. However, prior studies have not investigated lung cancer treatment patterns in Hispanic subgroups.
Methods: The study was conducted using the Surveillance, Epidemiology, and End Result program. We included 100,173 patients with histologically confirmed primary stage I-II non-small cell lung cancer (NSCLC) diagnosed between 2004 and 2013. Patients were classified into non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, American Indian and Pacific Islander, or Hispanic. Furthermore, Hispanic patients were further categorized based on their origin into: Mexicans, Puerto Ricans, Cubans and Central or South Americans. Unadjusted odds ratios (OR) and nominal regression analyses were used to assess the adjusted relationship between Hispanic subgroups and treatment (surgery, radiation, or no treatment) while controlling for age, sex, marital status, year of diagnosis, cancer stage, tumor size, histology and tumor site.
Results: Unadjusted analysis showed that Mexicans (OR: 0.61, 95% CI: 0.50-0.56), Cubans (OR: 0.40, 95% CI: 0.27-0.59), and South and Central Americans (OR: 0.80, 95% CI: 0.59-1.07) were less likely to undergo surgery compared to non-Hispanic whites. No significant differences resection rates were observed for other Hispanic subgroups. Mexicans (OR: 0.78, 95% CI: 0.65-0.94), Cubans (OR: 0.52, 95% CI: 0.33-0.82), and South and Central Americans (OR: 0.85, 95% CI: 0.61-1.19) were also less likely to undergo radiation compared to non-Hispanic whites. Adjusted analyses also showed lower rates of treatments among Mexicans (OR: 0.78, 95% CI: 0.64-0.97 and OR: 0.72, 95% CI: 0.57-0.90 for surgery and radiation, respectively) and Cubans (OR: 0.31, 95% CI: 0.19-0.50 and OR: 0.4795% CI: 0.28-0.79 for surgery and radiation, respectively) compared to non-Hispanic whites, but not Puerto Ricans or Hispanics from South or Central America.
Conclusions: We found considerable heterogeneity in disparities in lung cancer care among different Hispanic subgroups living in the United States with Mexicans and Cubans having the lower odds of treatment for early stage NSCLC. Additional research into the factors underlying these differences in treatment is needed to address these important gaps in care.
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