Disparities in stage at presentation among Hispanic and Latinx patients with non-small-cell lung cancer in the United States Journal Article
| Authors: | Dee, E. C.; Swami, N.; Kazzi, B.; Lapen, K.; Franco, I.; Jain, B.; Patel, T. A.; Mahal, B. A.; Rimner, A.; Wu, A.; Iyengar, P.; Li, B.; Florez, N.; Gomez, D. R. |
| Article Title: | Disparities in stage at presentation among Hispanic and Latinx patients with non-small-cell lung cancer in the United States |
| Abstract: | PURPOSEHispanic and Latinx people in the United States are the fastest-growing ethnic group. However, previous studies in non-small-cell lung cancer (NSCLC) often analyze these diverse communities in aggregate. We aimed to identify differences in NSCLC stage at diagnosis in the US population, focusing on disaggregated Hispanic/Latinx individuals.METHODSData from the National Cancer Database from 2004 to 2018 identified patients with primary NSCLC. Individuals were disaggregated by racial and ethnic subgroup and Hispanic country of origin. Ordinal logistic regression adjusting for age, facility type, income, educational attainment, comorbidity index, insurance, and year of diagnosis was used to create adjusted odds ratios (aORs), with higher odds representing diagnosis at later-stage NSCLC.RESULTSOf 1,565,159 patients with NSCLC, 46,616 were Hispanic/Latinx (3.0%). When analyzed in the setting of race and ethnicity, Hispanic patients were more likely to be diagnosed with metastatic disease compared with non-Hispanic White (NHW) patients: 47.0% for Hispanic Black, 46.0% Hispanic White, and 44.3% of Hispanic other patients versus 39.1% of non-Hispanic White patients (P <.001 for all). By country of origin, 51.4% of Mexican, 41.7% of Puerto Rican, 44.6% of Cuban, 50.8% of South or Central American, 48.4% of Dominican, and 45.6% of other Hispanic patients were diagnosed with metastatic disease, compared with 39.1% of NHWs. Conversely, 20.2% of Mexican, 26.9% of Puerto Rican, 24.2% of Cuban, 22.5% of South or Central American, 23.7% of Dominican, and 24.5% of other Hispanic patients were diagnosed with stage I disease, compared with 30.0% of NHWs. All Hispanic groups were more likely to present with later-stage NSCLC than NHW patients (greatest odds for Mexican patients, aOR, 1.44; P <.001).CONCLUSIONHispanic/Latinx patients with non-small-cell lung cancer were more likely to be diagnosed with advanced disease compared with NHWs. Disparities persisted upon disaggregation by both race and country of origin, with over half of Mexican patients with metastatic disease at diagnosis. Disparities among Hispanic/Latinx groups by race and by country of origin highlight the shortcomings of treating these groups as a monolith and underscore the need for disaggregated research and targeted interventions. © American Society of Clinical Oncology. |
| Keywords: | adult; aged; major clinical study; clinical feature; united states; cancer staging; cancer diagnosis; metastasis; carcinoma, non-small-cell lung; lung neoplasms; cohort analysis; age; medicaid; medicare; lung tumor; population research; comorbidity; cancer registry; educational status; ethnic difference; racial disparity; health disparity; caucasian; hispanic; non small cell lung cancer; private health insurance; mexico; humans; human; male; female; article; black person; puerto rican; medically uninsured; mexican; dominican republic; household income; late onset disorder; hispanic or latino; central american; cuban |
| Journal Title: | JCO Oncology Practice |
| Volume: | 20 |
| Issue: | 4 |
| ISSN: | 2688-1527 |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2024-04-01 |
| Start Page: | 525 |
| End Page: | 537 |
| Language: | English |
| DOI: | 10.1200/op.23.00474 |
| PUBMED: | 38252900 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Daniel R. Gomez -- Source: Scopus |
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