Intra-Ethnic and Geographic Disparities in Stage at Diagnosis for Non-Small Cell Lung Cancer.

IF 9.9 1区医学 Q1 ONCOLOGY

JNCI Journal of the National Cancer Institute Pub Date : 2024-08-21 DOI:10.1093/jnci/djae199

Qinran Liu, Heidy N Medina, Tulay Koru-Sengul, Estelamari Rodriguez, Gilberto Lopes, Frank J Penedo, Farhad Islami, Paulo S Pinheiro

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引用次数: 0

Abstract

Background: Despite the importance of early detection for lung cancer outcomes, staging disparities among the growing US Hispanic population remain underexplored. This population-based study aimed to identify racial-ethnic disparities among non-Hispanic White, non-Hispanic Black, and Hispanic (including specific subgroups) patients in stage at diagnosis for potentially curable non-small cell lung cancer (NSCLC).

Methods: Incident NSCLC cases (2005-2018) were extracted from the Florida cancer registry. Stage was categorized as early (localized/regional) or advanced (distant). Multivariable logistic regression assessed the association between race/ethnicity and stage at diagnosis, adjusting for socioeconomic status, smoking, and clinical factors.

Results: Among 157,034 NSCLC patients, 47.8% were diagnosed at an advanced-stage. Multivariable models showed higher odds of advanced-stage diagnosis for non-Hispanic Blacks (ORadj=1.22; 95%CI: 1.17-1.26) and Hispanics (ORadj=1.03; 95%CI: 1.00-1.08) compared to non-Hispanic Whites. Regional differences were stark for Hispanics compared to non-Hispanic Whites: ORadj 0.96 (95%CI: 0.91-1.01) in South Florida vs 1.12 (95%CI: 1.05-1.19) in the rest of Florida. In South Florida, Central Americans (ORadj=1.49; 95%CI: 1.20-1.85) were the only Hispanic group showing a staging disadvantage compared to non-Hispanic Whites.

Conclusion: Pronounced disparities in NSCLC staging among non-Hispanic Black and Hispanic populations, with notable regional variations within Florida's Hispanic communities, indicate that targeted interventions could significantly enhance early detection. The relative advantage observed in nearly all minority groups in multicultural South Florida compared to the rest of Florida underscores the need for future research exploring how specific Hispanic and multiracial sociocultural contexts can positively influence the landscape of cancer early detection across the US.

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非小细胞肺癌诊断分期的种族内和地域差异。

背景：尽管早期检测对肺癌的预后非常重要，但在不断增长的美国拉美裔人口中，分期差异仍未得到充分探索。这项以人群为基础的研究旨在确定非西班牙裔白人、非西班牙裔黑人和西班牙裔（包括特定亚群）患者在可能治愈的非小细胞肺癌（NSCLC）诊断分期方面的种族-民族差异：方法：从佛罗里达州癌症登记处提取非小细胞肺癌病例（2005-2018 年）。分期分为早期（局部/区域性）和晚期（远处）。多变量逻辑回归评估了种族/民族与诊断时分期之间的关系，并对社会经济状况、吸烟和临床因素进行了调整：在 157,034 名 NSCLC 患者中，47.8% 被诊断为晚期。多变量模型显示，与非西班牙裔白人相比，非西班牙裔黑人（ORadj=1.22；95%CI：1.17-1.26）和西班牙裔美国人（ORadj=1.03；95%CI：1.00-1.08）确诊晚期的几率更高。与非西班牙裔白人相比，西班牙裔的地区差异非常明显：南佛罗里达州的 ORadj 为 0.96（95%CI：0.91-1.01），而佛罗里达州其他地区的 ORadj 为 1.12（95%CI：1.05-1.19）。在南佛罗里达州，与非西班牙裔白人相比，中美洲人（ORadj=1.49；95%CI：1.20-1.85）是唯一显示出分期劣势的西班牙裔群体：结论：非西班牙裔黑人和西班牙裔人群在NSCLC分期方面存在明显差异，佛罗里达州的西班牙裔社区也存在明显的地区差异，这表明有针对性的干预措施可以显著提高早期检测率。与佛罗里达州其他地区相比，在多元文化的南佛罗里达州几乎所有少数族裔群体中都观察到了相对优势，这突出表明今后有必要开展研究，探索特定的西班牙裔和多种族社会文化背景如何对全美癌症早期检测工作产生积极影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JNCI Journal of the National Cancer Institute 医学-肿瘤学

CiteScore

17.00

自引率

2.90%

发文量

203

审稿时长

4-8 weeks

期刊介绍： The Journal of the National Cancer Institute is a reputable publication that undergoes a peer-review process. It is available in both print (ISSN: 0027-8874) and online (ISSN: 1460-2105) formats, with 12 issues released annually. The journal's primary aim is to disseminate innovative and important discoveries in the field of cancer research, with specific emphasis on clinical, epidemiologic, behavioral, and health outcomes studies. Authors are encouraged to submit reviews, minireviews, and commentaries. The journal ensures that submitted manuscripts undergo a rigorous and expedited review to publish scientifically and medically significant findings in a timely manner.