Racial Disparities in Lung Cancer Stage of Diagnosis Among Adults Living in the Southeastern United States.
Chest
; 163(5): 1314-1327, 2023 05.
Article
en En
| MEDLINE
| ID: mdl-36435265
ABSTRACT
BACKGROUND:
Black Americans receive a diagnosis at later stage of lung cancer more often than White Americans. We undertook a population-based study to identify factors contributing to racial disparities in lung cancer stage of diagnosis among low-income adults. RESEARCH QUESTION Which multilevel factors contribute to racial disparities in stage of lung cancer at diagnosis? STUDY DESIGN ANDMETHODS:
Cases of incident lung cancer from the prospective observational Southern Community Cohort Study were identified by linkage with state cancer registries in 12 southeastern states. Logistic regression shrinkage techniques were implemented to identify individual-level and area-level factors associated with distant stage diagnosis. A subset of participants who responded to psychosocial questions (eg, racial discrimination experiences) were evaluated to determine if model predictive power improved.RESULTS:
We identified 1,572 patients with incident lung cancer with available lung cancer stage (64% self-identified as Black and 36% self-identified as White). Overall, Black participants with lung cancer showed greater unadjusted odds of distant stage diagnosis compared with White participants (OR,1.29; 95% CI, 1.05-1.59). Greater neighborhood area deprivation was associated with distant stage diagnosis (OR, 1.58; 95% CI, 1.19-2.11). After controlling for individual- and area-level factors, no significant difference were found in distant stage disease for Black vs White participants. However, participants with COPD showed lower odds of distant stage diagnosis in the primary model (OR, 0.72; 95% CI, 0.53-0.98). Interesting and complex interactions were observed. The subset analysis model with additional variables for racial discrimination experiences showed slightly greater predictive power than the primary model.INTERPRETATION:
Reducing racial disparities in lung cancer stage at presentation will require interventions on both structural and individual-level factors.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
2_ODS3
Problema de salud:
1_acesso_equitativo_servicos
/
2_cobertura_universal
Asunto principal:
Grupos Raciales
/
Neoplasias Pulmonares
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Chest
Año:
2023
Tipo del documento:
Article
País de afiliación:
Túnez