Understanding the Social Risk Factors That Avert Equitable Lung Cancer Care

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Christopher M. Kapp, Chelsi Green, Jeffrey Thiboutot, Jeremy Kim, Mary M. Pasquinelli, Benjamin Aronson, A. Christine Argento
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Abstract

Lung cancer remains the leading cause of cancer death in the United States. There is an association between certain social determinants of health (SDOH) and adverse cancer outcomes. These include Black race and low-income, which are associated with poorer adherence to lung cancer screening and presentation at a later stage of disease. We conducted a retrospective review of all patients with a diagnosis of lung cancer at a single urban, academic center from 2015 to 2021. Demographic data including race and clinical data including time taken to progress through various checkpoints (ie, concerning CT scan to diagnosis, diagnosis to treatment) were collected. Income data was approximated based on population medians at patient's home address zip code. A total of 550 patients were included in the final analysis. The study population was 57.4% Black and 61.2% of patients presenting with a household income of $40,000 US Dollars or lower based on approximated median household income. The time from CT scan to first treatment for the entire cohort was 121.3 days with no statistically significant variance by race. However, among patients presenting at stage IV, 72.7% were black and 76.0% resided in a zip code with a median income < $40,000. This study demonstrated no significant delays in progressing through checkpoints of lung cancer diagnosis and treatment on the basis of race or income approximation. Black patients and patients in low-income households were diagnosed with lung cancer at a more advanced stage. Efforts to close the gap in lung cancer disparities should be focused on targeting screening and early identification toward social groups that may be at highest risk of late presentation. Institutional focus on patient navigation through these stages should be paramount. There were no delays in progression to lung cancer diagnostic and therapeutic milestones based on race or income approximation.
了解阻碍公平肺癌治疗的社会风险因素
肺癌仍然是美国癌症死亡的主要原因。某些健康的社会决定因素(SDOH)与癌症的不良后果之间存在关联。这些因素包括黑人种族和低收入,这与较差的肺癌筛查依从性和较晚的发病阶段有关。我们对 2015 年至 2021 年期间在一个城市学术中心确诊为肺癌的所有患者进行了回顾性研究。我们收集了包括种族在内的人口统计学数据和包括通过不同检查点(即从 CT 扫描到诊断、从诊断到治疗)所需时间在内的临床数据。收入数据是根据患者家庭住址邮政编码的人口中位数估算的。共有 550 名患者被纳入最终分析。研究人群中 57.4% 为黑人,61.2% 的患者家庭收入在 40,000 美元或以下(根据家庭收入中位数估算)。整个组群从 CT 扫描到首次治疗的时间为 121.3 天,不同种族的差异无统计学意义。不过,在 IV 期患者中,72.7% 是黑人,76.0% 居住在收入中位数低于 4 万美元的邮编区。这项研究表明,在肺癌诊断和治疗的检查点上,并没有因种族或收入近似而出现明显的延误。黑人患者和低收入家庭患者被诊断出肺癌时已是晚期。缩小肺癌差异的努力应集中在针对晚期发病风险最高的社会群体进行筛查和早期识别。在这些阶段中,机构对患者指导的重视应该是最重要的。在肺癌诊断和治疗的阶段性进展方面,没有出现因种族或收入近似而导致的延误。
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
CiteScore
7.20
自引率
4.30%
发文量
567
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