ASPO Abstracts
Recent patterns and disparities in lung cancer treatment: National Program of Cancer Registries
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose: Treatment for lung cancer can improve prognosis, but five-year survival remains <25%. We describe recent patterns in first-course treatment for lung cancer and examine disparities in treatment by sociodemographic characteristics. This study contributes new information on lung cancer treatment among cases reported to registries that cover 96% of the US population. Methods: We used 2015-2019 data from the National Program of Cancer Registries, covering 45 US states and District of Columbia. We restricted our analysis to adults aged >20 years at diagnosis with lung and bronchus cancer. We produced descriptive statistics to examine patterns in surgery, chemotherapy, radiation, and immunology. We ran five multivariable logistic regressions to model odds of receiving each treatment, and at least one treatment, by sociodemographic characteristics including census tract poverty level, sex, race, and ethnicity. We adjusted all models for histology and stage. Results: Among 892,615 cases, the percent receiving surgery, chemotherapy, radiation, and immunotherapy was 23%, 42%, 42%, and 12%, respectively. Residents of high- vs. low-poverty neighborhoods were less likely to receive surgery (OR=0.77; 95% CI: 0.76, 0.78), chemotherapy (OR=0.83; 95% CI: 0.82, 0.84), and immunotherapy (OR=0.84; 95% CI: 0.82, 0.85). Disparities varied according to treatment type; for example, females were less likely to receive chemotherapy (OR=0.95; 95% CI: 0.94, 0.96), radiation (OR=0.94; 95% CI: 0.94, 0.95), and immunotherapy (OR=0.97; 95% CI: 0.95, 0.98), but more likely to receive surgery (OR=1.16; 95% CI: 1.15, 1.17). When adjusted for histology and stage, those aged >45 years (vs. 20-44); female; Asian or Pacific Islander, Black, or Hispanic (vs. White); and living in high-poverty areas had significantly lower odds of receiving at least one treatment. Conclusion: Chemotherapy and radiation were the most common first-course treatments for lung cancer. Receipt of at least one treatment was lower among those living in high-poverty areas and among racial and ethnic minorities. Future investigations accounting for factors such as systemic racism and healthcare coverage could identify reasons for disparities to inform potential interventions.
Keywords: lung cancer, treatment, disparities, cancer registry