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Purpose <p>Non-small cell lung cancer (NSCLC) is the leading cause of cancer mortality in California, with Non-Hispanic Black (NHB) patients experiencing the highest mortality rates. Disparities in receipt of guideline-concordant treatment (GCT) contribute to these outcomes. This population-based study analyzed racial and ethnic differences in GCT receipt among early-stage NSCLC patients.</p> Methods <p>Patients diagnosed with early-stage NSCLC (tumors ≤ 4&#xa0;cm, no lymph node involvement, and no distant metastases) between 2012 and 2022 were identified from the Los Angeles County Cancer Surveillance Program. Logistic regression evaluated associations between race/ethnicity and receipt of GCT (surgery or radiation only vs. no treatment or multiple treatments), adjusting for potential confounders.</p> Results <p>In our sample (<i>n</i> = 2,857), the average age was 69.6&#xa0;years, 63.2% were female, mean tumor size was 1.9&#xa0;cm, and the cohort was 57.3% Non-Hispanic White (NHW), 8.9% NHB, 14.2% Hispanic, and 18.8% Asian/Pacific Islander (API). While most patients (87.4%) received GCT, NHB and Hispanic patients had higher rates of non-GCT treatment (18.0% and 15.8%, respectively; <i>p</i> &lt;&#xa0;0.001). NHB patients had significantly higher odds of not receiving GCT compared with NHW patients (OR: 1.55, 95% CI: 1.07–2.26; <i>p</i> &lt; 0.05). No significant differences were observed for API or Hispanic patients.</p> Conclusion <p>Addressing disparities in GCT for patients diagnosed with early-stage NSCLC is critical to improving survival outcomes. Future studies identifying factors influencing a patient’s and physician’s decision to receive, recommend, and adhere to GCT guidelines are needed to understand the complexity of treatment decision-making.</p>

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Racial and ethnic disparities in receipt of guideline-concordant treatment for early-stage non-small cell lung cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月1日

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  • Miriam L. Gorbatov,
  • Angel Arizpe,
  • Elizabeth A. David,
  • Lihua Liu,
  • Myles Cockburn,
  • Albert J. Farias

摘要

Purpose

Non-small cell lung cancer (NSCLC) is the leading cause of cancer mortality in California, with Non-Hispanic Black (NHB) patients experiencing the highest mortality rates. Disparities in receipt of guideline-concordant treatment (GCT) contribute to these outcomes. This population-based study analyzed racial and ethnic differences in GCT receipt among early-stage NSCLC patients.

Methods

Patients diagnosed with early-stage NSCLC (tumors ≤ 4 cm, no lymph node involvement, and no distant metastases) between 2012 and 2022 were identified from the Los Angeles County Cancer Surveillance Program. Logistic regression evaluated associations between race/ethnicity and receipt of GCT (surgery or radiation only vs. no treatment or multiple treatments), adjusting for potential confounders.

Results

In our sample (n = 2,857), the average age was 69.6 years, 63.2% were female, mean tumor size was 1.9 cm, and the cohort was 57.3% Non-Hispanic White (NHW), 8.9% NHB, 14.2% Hispanic, and 18.8% Asian/Pacific Islander (API). While most patients (87.4%) received GCT, NHB and Hispanic patients had higher rates of non-GCT treatment (18.0% and 15.8%, respectively; p < 0.001). NHB patients had significantly higher odds of not receiving GCT compared with NHW patients (OR: 1.55, 95% CI: 1.07–2.26; p < 0.05). No significant differences were observed for API or Hispanic patients.

Conclusion

Addressing disparities in GCT for patients diagnosed with early-stage NSCLC is critical to improving survival outcomes. Future studies identifying factors influencing a patient’s and physician’s decision to receive, recommend, and adhere to GCT guidelines are needed to understand the complexity of treatment decision-making.