Research article summary (published 29 Jun 2009):

Race and sex differences in the receipt of timely and appropriate lung cancer treatment.

Full Abstract

BACKGROUND: Previous research suggests that disparities in non-small-cell lung cancer (NSCLC) survival can be explained in part by disparities in the receipt of cancer treatment. Few studies, however, have considered race and sex disparities in the timing and appropriateness of treatment across stages of diagnosis. OBJECTIVE: To evaluate the relationship of sex and race with the receipt of timely and clinically appropriate NSCLC treatment for each stage of diagnosis. METHOD: Surveillance Epidemiology and End Result data linked to Medicare claims for beneficiaries diagnosed with NSCLC between 1995 and 1999 were used to evaluate the relationship between race and sex with timely and appropriate NSCLC treatment while controlling for other demographic characteristics, comorbidities, socioeconomic status, and provider supply (N = 22,145). RESULTS: Overall adjusted rates of timely and appropriate treatment are 37.2%, 58.1%, and 29.2% for Medicare beneficiaries diagnosed with stage I or II, III, and IV NSCLC, respectively. Among stage I or II patients, women were 25% less likely to receive timely surgical resection relative to men, and blacks were 66% less likely to receive timely and appropriate treatment than whites. Black men were least likely to receive resection (22.2% compared with 43.7% for white men). Blacks were 34% less likely to receive timely surgery, chemotherapy, or radiation for stage III disease and were 51% less likely to receive chemotherapy in a timely fashion for stage IV disease relative to whites. CONCLUSION: Significant variations in appropriate timely treatment were found within and across stages of diagnosis, confirming that sex and race differences in NSCLC treatment exist.

Author information

Author/s: Shugarman, Lisa R (LR); Mack, Katherine (K); Sorbero, Melony E S (ME); Tian, Haijun (H); Jain, Arvind K (AK); Ashwood, J Scott (JS); Asch, Steven M (SM);

Affiliation: RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, USA. lisas(-atsign-)rand.org

Grants: R04-RH03596-01-00 (Agency:PHS HHS)

Journal and publication information

Publication Type: Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.

Journal: Medical care (Med Care), published in United States. (Language: eng)

Reference: 2009-Jul; vol 47 (issue 7) : pp 774-81

Dates: Created 2009/06/25; Completed 2009/07/16;

PMID: 19536007, status: MEDLINE (last retrieval date: 7/25/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

African Americans - ethnology; statistics & numerical data Aged Aged, 80 and over Carcinoma, Non-Small-Cell Lung - diagnosis; ethnology; therapy European Continental Ancestry Group - ethnology; statistics & numerical data Female Guideline Adherence - statistics & numerical data Health Services Accessibility - statistics & numerical data Health Services Research Healthcare Disparities - statistics & numerical data Humans Insurance Claim Reporting - statistics & numerical data Logistic Models

Lung Neoplasms - diagnosis; ethnology; therapy Male Medicare - statistics & numerical data Men Multivariate Analysis Patient Selection Physician's Practice Patterns - statistics & numerical data Practice Guidelines as Topic SEER Program Sensitivity and Specificity Sex Factors United States - epidemiology Women

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