Asian, Black patients with lung cancer face longer wait times to radiation treatment
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Key findings:
- Asian patients had the longest mean time to radiation therapy initiation, at 71.9 days.
- Asian, Black and white patients all experienced longer mean time to radiation therapy at academic facilities compared with comprehensive cancer care centers.
Asian and Black patients with lung cancer experienced longer delays to radiation treatment than their white counterparts, according to study results published in Health Equity.
“Our findings shed light on the potential presence and impact of structural racism on patients seeking cancer treatment,” Rajesh Balkrishnan, PhD, co-program director of population health and prevention sciences and director of the Cancer Control Core at University of Virginia Cancer Center, told Healio.
Background and methods
Time to radiation therapy is known to be associated with mortality outcomes among patients with non-small cell lung cancer.
Balkrishnan and colleagues pooled data from the U.S. National Cancer Database and sought to assess the prevalence and magnitude of racial disparities in mean time to radiation therapy for 222,715 patients with stage I (24%), stage II (13%) and stage III (62%) NSCLC (median age at diagnosis, 68 years; 55% men; 12% Black) receiving radiation across various treatment facilities.
Results
Researchers reported a mean time to radiation therapy of 61.7 days (95% CI, 61.6-61.9) for the overall cohort.
Asian patients had the longest mean time to radiation therapy (71.9 days; 95% CI, 69.8-73.9), followed by Black patients (65.9 days; 95% CI, 65.2-66.6) and white patients (60.9 days; 95% CI, 60.7-61.2).
Results also showed that white patients treated at community centers experienced shorter mean time to radiation therapy (57.7 days; 95% CI, 57.1-58.4) than white patients treated at academic centers (65.4 days; 95% CI, 61-62.3).
Black patients treated at comprehensive cancer centers also experienced shorter mean time to radiation therapy (59.8 days; 95% CI, 58.7-60.9) than Black patients treated at academic facilities (71.4 days; 95% CI, 70.4-72.5), as did Asian patients at community centers (64.8 days; 95% CI, 58.7-71) vs. academic facilities (74 days; 95% CI, 72.8-78.9).
Researchers observed a significant difference in mean time to radiation therapy across all facilities among white patients (P < .0001), Black patients (P < .0001) and Asian patients (P = .0002).
Moreover, Asian patients experienced the longest mean time to radiation therapy for all facilities, except academic facilities. Results showed Asian patients treated at comprehensive community facilities experienced a mean time to radiation therapy of 69.8 days compared with a mean time to radiation therapy of 59.8 days among Black patients and 58.7 days among white patients.
Implications
“We recommend further investigation into the societal determinants that perpetuate disparity in time to radiation therapy and potential interventions in the clinical setting to improve cultural and racial sensitivity among health care professionals,” Balkrishnan told Healio. “Collaboration among providers, community stakeholders and organizations is much needed to increase accessibility and patient knowledge of cancer and to overcome existing disparities in timely care for [patients with lung cancer].”
References:
- Minorities face longer wait times for vital lung cancer treatment, study finds (press release). Available at: www.sciencedaily.com/releases/2022/10/221025090509.htm. Published Oct. 25, 2022. Accessed Jan. 5, 2023.
- Rekulapelli A, et al. Health Equity. 2022;doi:10.1089/heq.2022.0104.
For more information:
Rajesh Balkrishnan, PhD, can be reached at rb9ap@virginia.edu.
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