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M. Block



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    MO11 - Screening and Epidemiology (ID 131)

    • Event: WCLC 2013
    • Type: Mini Oral Abstract Session
    • Track: Imaging, Staging & Screening
    • Presentations: 1
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      MO11.07 - Exploring Disparities in Health Care Outcomes in Minority Populations with Small (SCLC) and Non-small cell lung cancers (NSCLC). (ID 1237)

      16:50 - 16:55  |  Author(s): M. Block

      • Abstract
      • Presentation
      • Slides

      Background
      There are population-specific differences in the presence of lung cancer, these are related with: health outcomes, quality of health care and access to health care services that exist across racial and ethnic groups. Disparities represent a lack of efficiency within the health care system and therefore account for unnecessary costs. Few publications are available about disparities in African-American (AA) populations with lung cancer and very few about Hispanic (H) populations with this disease.

      Methods
      We reviewed registry data on 2,255 pts with non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) treated during last 10 years (2002-2011) at Memorial Health Care System. The main objective of the study was to evaluate differences in lung cancer survival according to ethnicity. Chi-square was used to compare distribution of tumor stage. Survival curves were compared using log-rank test for each of the tumor stages. Adjusted hazard ratios (AHR) and 95% confidence intervals (95% CI) were reported based on the results of a multivariate Cox regression model for overall survival (OS) with adjustment for gender, age at diagnosis, race, stage and health insurance

      Results
      A total of 1940 pts (86%) had the diagnosis of NSCLC, the rest were SCLC. There were 1170 (52%) females. Non-Hispanic whites (NHW) were 1,791 pts (79%), Hispanics (H) 266 (12%) and African-American (AA) 149 (7%). Fifty eight percent of patients had stage III/IV at diagnosis. 2054 of the pts were insured (91%). There was a significant difference in age at diagnosis among H (66.5 y), AA (64.4y) and WNH (69.5y). The probability of being diagnosed at a late stage (IIIB/IV) was two times higher among AA compared to NHW (OR= 1.77, p<0.05) or H (OR) = 1.67, p <0.05). There was no survival difference between NSCLC and SCLC (19m vs. 16m). Females with NSCLC lived significantly longer than males (Adjusted Hazard ratio (AHR= 1.14 p<0.01). The same was true for SCLC (AHR = 1.43 p < 0.01). Significant predictors for worse survival for patients with NSCLC were: older age at diagnosis (AHR = 1.01, p<0.001), male gender (AHR=1.12, p<0.05) and late stage at diagnosis (AHR=2.27, p<0.001). Insurance and ethnicity were not significant predictors of survival.

      Conclusion
      There are significant disparities in presentation and outcomes among minority patients (AA and H) with lung cancer. We will further evaluate if other social or genetic factors can explain these disparities.

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