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Socioeconomic disparities in immunotherapy use among advanced-stage non-small cell lung cancer patients: analysis of the National Cancer Database.
Gupta, Anjali; Omeogu, Chioma; Islam, Jessica Y; Joshi, Ashwini; Zhang, Dongyu; Braithwaite, Dejana; Karanth, Shama D; Tailor, Tina D; Clarke, Jeffrey M; Akinyemiju, Tomi.
Afiliação
  • Gupta A; Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27708, USA.
  • Omeogu C; Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27708, USA.
  • Islam JY; Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27708, USA.
  • Joshi A; Cancer Epidemiology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
  • Zhang D; Department of Population Health Sciences, Duke University School of Medicine, 215 Morris Street, Durham, NC, 27708, USA.
  • Braithwaite D; Johnson and Johnson, Medical Device Epidemiology, New Brunswick, NJ, USA.
  • Karanth SD; Department of Epidemiology, University of Florida, Gainesville, FL, USA.
  • Tailor TD; Institute on Aging, University of Florida, Gainesville, FL, USA.
  • Clarke JM; Department of Radiology, Duke University School of Medicine, Durham, NC, USA.
  • Akinyemiju T; Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
Sci Rep ; 13(1): 8190, 2023 05 20.
Article em En | MEDLINE | ID: mdl-37210410
Socioeconomic and racial disparities exist in access to care among patients with non-small cell lung cancer (NSCLC) in the United States. Immunotherapy is a widely established treatment modality for patients with advanced-stage NSCLC (aNSCLC). We examined associations of area-level socioeconomic status with receipt of immunotherapy for aNSCLC patients by race/ethnicity and cancer facility type (academic and non-academic). We used the National Cancer Database (2015-2016), and included patients aged 40-89 years who were diagnosed with stage III-IV NSCLC. Area-level income was defined as the median household income in the patient's zip code, and area-level education was defined as the proportion of adults aged ≥ 25 years in the patient's zip code without a high school degree. We calculated adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) using multi-level multivariable logistic regression. Among 100,298 aNSCLC patients, lower area-level education and income were associated with lower odds of immunotherapy treatment (education: aOR 0.71; 95% CI 0.65, 0.76 and income: aOR 0.71; 95% CI 0.66, 0.77). These associations persisted for NH-White patients. However, among NH-Black patients, we only observed an association with lower education (aOR 0.74; 95% CI 0.57, 0.97). Across all cancer facility types, lower education and income were associated with lower immunotherapy receipt among NH-White patients. However, among NH-Black patients, this association only persisted with education for patients treated at non-academic facilities (aOR 0.70; 95% CI 0.49, 0.99). In conclusion, aNSCLC patients residing in areas of lower educational and economic wealth were less likely to receive immunotherapy.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Neoplasias Pulmonares Limite: Adult / Humans País/Região como assunto: America do norte Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Pulmonar de Células não Pequenas / Neoplasias Pulmonares Limite: Adult / Humans País/Região como assunto: America do norte Idioma: En Ano de publicação: 2023 Tipo de documento: Article