BOSTON, September 26, 2016 -- Enhanced, culturally-competent communication with early stage lung cancer patients can narrow racial gaps in curative treatment completion and increase treatment rates for all races, according to research presented today at the 58th Annual Meeting of the American Society for Radiation Oncology (ASTRO). The study, part of a project supported by the National Cancer Institute, found that multiple, coordinated modalities of patient support essentially eliminated the inequity in curative treatment and improved completion of care for all patients.

Due to major breakthroughs in lung cancer screening and treatment, many patients with early stage lung cancer can now be cured with minimal side effects, but disparities negatively impact these potentially high survival rates for vulnerable populations. Many studies have shown, for example, that curative treatment rates for early stage lung cancer are lower for African American patients than for White patients, which contributes to higher death rates for African Americans.

The Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) trial is an NIH-sponsored multi-institutional project designed to reduce racial disparities and increase treatment utilization for early stage lung and breast cancer, especially among African Americans. The ACCURE intervention consists of multiple layers of patient support, including an electronic health record system that signals whenever a patient misses an appointment or anticipated milestone in care; nurse navigators specially trained in race-related barriers to care; presentation of race-specific treatment feedback to care teams; and quarterly health equity training sessions for staff drawing on evidence from community-based participatory research.
Findings are based on data from 100 patients with stage I or II lung cancer enrolled into the prospective randomized trial between 2013 and 2015; of these patients, 25 percent were black, compared to a local population rate of 13 percent. Primary outcomes included rates of receiving two potentially curative lung cancer treatments, stereotactic body radiation therapy (SBRT) and surgical resection (R). Rates among study participants were measured against other patient records at the cancer centers involved in the trial. Records for all patients treated between 2007 and 2011 (n = 2,044) served as baseline data, and records for all patients treated between 2014 and 2015 (n = 393) served as a control group. Researchers conducted multivariate analyses to control for Charlson comorbidity score, prognosis (i.e., disease stage I or II) and patient age.

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