Details:

Alternative Title:
Lung Cancer
Personal Author:
Check, Devon K. ; Albers, Kathleen B. ; Uppal, Kanti M. ; Suga, Jennifer Marie ; Adams, Alyce S. ; ... More +
Check, Devon K. ; Albers, Kathleen B. ; Uppal, Kanti M. ; Suga, Jennifer Marie ; Adams, Alyce S. ; Habel, Laurel A. ; Quesenberry, Charles P. ; Sakoda, Lori C. ; Less -
Description:
Objectives: To examine the role of uniform access to care in reducing racial/ethnic disparities in receipt of resection for early stage non-small cell lung cancer (NSCLC) by comparing integrated health system member patients to demographically similar non-member patients. Materials and Methods: Using data from the California Cancer Registry, we conducted a retrospective cohort study of patients from four racial/ethnic groups (White, Black, Hispanic, Asian/Pacific Islander), aged 21 to 80, with a first primary diagnosis of stage I or II NSCLC between 2004 and 2011, in counties served by Kaiser Permanente Northern California (KPNC) at diagnosis. Our cohort included 1,565 KPNC member and 4,221 non-member patients. To examine the relationship between race/ethnicity and receipt of surgery stratified by KPNC membership, we used modified Poisson regression to calculate risk ratios (RR) adjusted for patient demographic and tumor characteristics. Results: Black patients were least likely to receive surgery regardless of access to integrated care (64–65% in both groups). The magnitude of the black-white difference in the likelihood of surgery receipt was similar for members (RR: 0.82, 95% CI: 0.73–0.93) and non-members (RR: 0.86, 95% CI: 0.80–0.94). Among members, roughly equal proportions of Hispanic and White patients received surgery; however, among non-members, Hispanic patients were less likely to receive surgery (non-members, RR: 0.93, 95% CI: 0.86–1.00; members, RR: 0.98, 95% CI: 0.89–1.08). Conclusion: Disparities in surgical treatment for NSCLC were not reduced through integrated health system membership, suggesting that factors other than access to care (e.g., patient-provider communication) may underlie disparities. Future research should focus on identifying such modifiable factors.
Subject:
[+]
Access To Care
Adult
Aged
Aged, 80 And Over
Article
California
Cancer Care
Carcinoma, Non-Small-Cell Lung
Disparities
Female
Healthcare Disparities
Health Services Accessibility
Humans
Lung Neoplasms
Male
Middle Aged
Population Groups
Retrospective Studies
Young Adult

Source:
Lung Cancer. 125:51-56 ;
Pubmed ID:
30429038
Pubmed Central ID:
PMC6242353
Document Type:
Journal Article ;
Funding:
K07 CA188142/CA/NCI NIH HHS/United States ; U24 CA171524/CA/NCI NIH HHS/United States ;
K07 CA188142/CA/NCI NIH HHS/United States ; U24 CA171524/CA/NCI NIH HHS/United States ; Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:58ca3f299f9b5b12c7c41790fcbce0d3780e0c626497f41ecc3fd8882184234d
File Type:

Supporting Files

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