Racial and Ethnic Trends and Disparities in NSCLC

Kristin M Primm; Hui Zhao; Daphne C Hernandez; Shine Chang

doi:10.1016/j.jtocrr.2022.100374

Racial and Ethnic Trends and Disparities in NSCLC

JTO Clin Res Rep. 2022 Jul 2;3(8):100374. doi: 10.1016/j.jtocrr.2022.100374. eCollection 2022 Aug.

Authors

Kristin M Primm¹, Hui Zhao², Daphne C Hernandez³, Shine Chang¹

Affiliations

¹ Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
² Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
³ Cizik School of Nursing, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas.

Abstract

Introduction: Detailed evaluations of racial and ethnic trends and disparities in NSCLC outcomes are lacking, and it remains unclear whether recent advances in screening and targeted therapies for NSCLC have benefited all population groups equally.

Methods: Using the Surveillance, Epidemiology, and End Results 18-registry data, we evaluated trends in overall and stage-specific NSCLC incidence (2007-2018) among patients aged 55 to 79 years by sex and race and ethnicity. Overall and stage-specific 2-year cause-specific survival rates were calculated by sex and race and ethnicity. Health Disparities software calculated absolute (difference) and relative (ratio) disparity measures comparing racial and ethnic groups with the highest and lowest rates (range measures) and comparing white patients (reference group) with other groups (pairwise rate measures). Joinpoint software assessed changes in rates and disparities.

Results: Both men and women experienced substantial declines in NSCLC incidence from 2007 to 2018, largely due to significant declines in the incidence of distant-stage NSCLC over the study period (p < 0.05). During the same time period, the incidence of local-stage NSCLC significantly increased among black and Hispanic women (p < 0.05) and remained stable among all other groups. Overall, 2-year cause-specific survival rates improved across most racial and ethnic groups, especially among those diagnosed in regional and distant stages. For both sexes, absolute disparities in overall and stage-specific incidence of NSCLC significantly decreased over time (p < 0.05), whereas relative disparities remained unchanged. Pairwise comparison revealed persistent disparities in NSCLC burden between black and white men.

Conclusion: We found evidence of narrowing racial and ethnic disparities in NSCLC incidence over time; however, important disparities persist. More work is needed to ensure consistent and equitable access to high-quality screening, diagnosis, and treatment to reduce and eliminate cancer disparities.

Keywords: Disparities; Ethnicity; Non–small cell lung cancer; Race; Screening; Stage at diagnosis.