The Hispanic Paradox in Non-Small Cell Lung Cancer.

Q1 Medicine

Hematology/ Oncology and Stem Cell Therapy Pub Date : 2022-06-01 DOI:10.1016/j.hemonc.2021.02.004

Rohit Kumar, Franklin Castillero, Shruti Bhandari, Sindhu Malapati, Goetz Kloecker

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引用次数: 5

Abstract

Objective/background: According to the U.S. Census Bureau, 18% of the total population in the United States identified themselves as Hispanic in 2016 making it the largest minority group. This study aimed to evaluate the effect of Hispanic ethnicity on the overall survival of patients with non-small cell lung cancer (NSCLC) using a large national cancer database.

Methods: We used the National Cancer Database to identify patients diagnosed with NSCLC between 2010 and 2015. The two comparative groups for this study were non-Hispanic Whites (NHWs) and Hispanics. The primary outcome was overall survival.

Results: Of the 555,475 patients included in the study, 96.9% and 3.1% were NHWs and Hispanics with a median follow up of 12.6 months (interquartile range 4.1-30.6) and 12.1 months (interquartile range 3.8-29.5), respectively. Hispanics were more likely to be uninsured, and live in areas with lower median household income or education level. In the age-, sex-, and comorbidities-adjusted Cox model, the overall survival was significantly better in Hispanics compared with NHWs (hazard ratio [HR] 0.92, 95% confidence interval 0.90-0.93, p < .001). In a demographic, socioeconomic, clinical, and facility characteristics adjusted Cox model, Hispanics had further improvement in survival (HR 0.79, 95% confidence interval 0.78-0.81, p < .001). The survival advantage was seen in all cancer stages: Stage I-HR 0.76 (0.71-0.80), Stage II-HR 0.85 (0.79-0.92), Stage III-HR 0.81 (0.77-0.85), and Stage IV-HR 0.79 (0.77-0.81).

Conclusion: Hispanic ethnicity was associated with better survival in NSCLC. This survival advantage is likely the result of complex interactions amongst several physical, social, cultural, genomic, and environmental factors.

查看原文本刊更多论文

非小细胞肺癌的西班牙悖论。

目的/背景:根据美国人口普查局的数据，2016年，美国总人口中有18%的人认为自己是西班牙裔，使其成为最大的少数民族。本研究旨在利用大型国家癌症数据库评估西班牙裔对非小细胞肺癌(NSCLC)患者总生存率的影响。方法:我们使用国家癌症数据库来识别2010年至2015年间诊断为NSCLC的患者。本研究的两个比较组是非西班牙裔白人(NHWs)和西班牙裔。主要终点是总生存期。结果:在纳入研究的555,475例患者中，96.9%为nhw和3.1%为西班牙裔，中位随访时间分别为12.6个月(四分位数范围4.1-30.6)和12.1个月(四分位数范围3.8-29.5)。拉美裔更有可能没有保险，生活在家庭收入或教育水平中位数较低的地区。在年龄、性别和合并症校正的Cox模型中，西班牙裔患者的总生存率明显优于非裔美国人(风险比[HR] 0.92, 95%可信区间0.90-0.93,p < 0.001)。在人口统计学、社会经济、临床和设施特征调整后的Cox模型中，西班牙裔患者的生存率进一步提高(HR 0.79, 95%可信区间0.78-0.81,p < 0.001)。在所有癌症分期中均观察到生存优势:i期hr 0.76 (0.71-0.80)， ii期hr 0.85 (0.79-0.92)， iii期hr 0.81(0.77-0.85)和iv期hr 0.79(0.77-0.81)。结论:西班牙裔与NSCLC患者更好的生存率相关。这种生存优势可能是多种生理、社会、文化、基因组和环境因素复杂相互作用的结果。

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

Hematology/ Oncology and Stem Cell Therapy Medicine-Hematology

CiteScore

4.30

自引率

0.00%

发文量

审稿时长

27 weeks

期刊介绍： Hematology Oncology and Stem Cell Therapy is an international, peer-reviewed, open access journal that provides a vehicle for publications of high-quality clinical as well as basic science research reports in hematology and oncology. The contents of the journal also emphasize the growing importance of hematopoietic stem cell therapy for treatment of various benign and malignant hematologic disorders and certain solid tumors.The journal prioritizes publication of original research articles but also would give consideration for brief reports, review articles, special communications, and unique case reports. It also offers a special section for clinically relevant images that provide an important educational value.