Patients received one of four types of primary treatment for stage I NSCLC, including surgery only (67%), radiation only (19%), both surgery and radiation (3%) or no treatment/observation only (12%). The type of treatment patients received varied by race; while 67 percent of Caucasian patients and 72 percent of Asian/Pacific Islander patients underwent surgery, these rates were 56 percent and 58 percent for African-American and American Indian patients, respectively (p

Treatment type directly influenced the likelihood of surviving early-stage lung cancer. On multivariate analysis, patients who received definitive treatment for stage I NSCLC, whether surgery or SBRT, had improved survival rates, regardless of race, age or gender (compared with observation, surgery Hazard Ratio (HR) = 0.44, radiation HR = 0.70, surgery and radiation HR = 0.48, p


Overall survival (OS) and lung cancer-specific survival (CSS) also varied among the racial groups. At a median follow-up of 23 months after treatment, OS rates were highest for Asian/Pacific Islander patients (76%) and Caucasians (70%) and lowest for African Americans (65%) and American Indians (60%) (p p p

Even after accounting for differences in age, T stage, gender and treatment type, race influenced CSS. On multivariate analysis, CSS rates were lowest for American Indians (compared with Caucasians, HR = 1.35, p p

Several patient and disease characteristics, in addition to race, also independently influenced CSS. Outcomes were worse for male patients (compared with females, HR = 1.17, p p p

"Unfortunately, our findings are not particularly surprising. Multiple studies have documented racial disparities in the management and outcome of different cancers. As physicians, it becomes our responsibility to understand and address these inequalities," said Dr. Farach. "Most importantly, we must improve access to care and get patients to treatment. Other steps include investigating the biology of lung cancer in understudied groups and—at the individual level—taking more time to educate and build trust with our underserved patient populations."

The abstract, "Racial disparities in the treatment & outcome of stage I non-small cell lung cancer," will be presented in detail during the oral abstract session at the 2017 Multidisciplinary Thoracic Cancers Symposium in San Francisco (full details below). To schedule an interview with Dr. Farach or an outside expert, contact the ASTRO media relations team at press@astro.org or 703-286-1600.


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