Racial Disparities in Lung Cancer Stage of Diagnosis Among Adults Living in the Southeastern United States
Copyright © 2022 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved..
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 AND METHODS: 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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:163 |
|---|---|
| Enthalten in: |
Chest - 163(2023), 5 vom: 20. Mai, Seite 1314-1327 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Richmond, Jennifer [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 12.05.2023 Date Revised 27.05.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.chest.2022.11.025 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM349481768 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM349481768 | ||
| 003 | DE-627 | ||
| 005 | 20231226042728.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.chest.2022.11.025 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1164.xml |
| 035 | |a (DE-627)NLM349481768 | ||
| 035 | |a (NLM)36435265 | ||
| 035 | |a (PII)S0012-3692(22)04195-2 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Richmond, Jennifer |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Racial Disparities in Lung Cancer Stage of Diagnosis Among Adults Living in the Southeastern United States |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 12.05.2023 | ||
| 500 | |a Date Revised 27.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a 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 | ||
| 520 | |a RESEARCH QUESTION: Which multilevel factors contribute to racial disparities in stage of lung cancer at diagnosis? | ||
| 520 | |a STUDY DESIGN AND METHODS: 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 | ||
| 520 | |a 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 | ||
| 520 | |a INTERPRETATION: Reducing racial disparities in lung cancer stage at presentation will require interventions on both structural and individual-level factors | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
| 650 | 4 | |a United States | |
| 650 | 4 | |a lung cancer | |
| 650 | 4 | |a multilevel factors | |
| 650 | 4 | |a racial disparities | |
| 650 | 4 | |a stage at diagnosis | |
| 700 | 1 | |a Murray, Megan Hollister |e verfasserin |4 aut | |
| 700 | 1 | |a Milder, Cato M |e verfasserin |4 aut | |
| 700 | 1 | |a Blume, Jeffrey D |e verfasserin |4 aut | |
| 700 | 1 | |a Aldrich, Melinda C |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Chest |d 1970 |g 163(2023), 5 vom: 20. Mai, Seite 1314-1327 |w (DE-627)NLM000002720 |x 1931-3543 |7 nnns |
| 773 | 1 | 8 | |g volume:163 |g year:2023 |g number:5 |g day:20 |g month:05 |g pages:1314-1327 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.chest.2022.11.025 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 163 |j 2023 |e 5 |b 20 |c 05 |h 1314-1327 | ||