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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MSK Authors
  1. Daniel R Gomez
    237 Gomez
  2. Andreas Rimner
    525 Rimner
  3. Abraham Jing-Ching Wu
    401 Wu
  4. Bob Tingkan Li
    279 Li
  5. Kaitlyn Ann Lapen
    38 Lapen
  6. Edward Christopher Dee
    262 Dee
  7. Puneeth Iyengar
    41 Iyengar