Blacks with lung cancer have higher mortality rates than whites
Research Activities, September 2010, No. 361
Although treatment has improved for lung cancer, it remains the leading cause of cancer-associated mortality and the second most commonly diagnosed cancer. Blacks continue to have lower survival rates than whites. A recent study found that blacks with nonsmall-cell lung cancer (NSCLC) had a 22 percent greater overall risk of dying from all causes during the various stages of NSCLC. Blacks with stage III or IV NSCLC had a 22 percent greater risk of dying from all causes and 24 percent greater risk of dying from lung cancer in 2000-2002. Receipt of standard stage-specific treatment was significantly associated with longer survival, whereas poor socioeconomic status was associated with greater risk of dying.
A total of 70,901 elderly Medicare patients with stage I to IV NSCLC participated in the study. Researchers determined the time to death from the date of diagnosis. One group included patients with stage I or II disease, who are usually treated by surgery. The second group included patients with stage III or IV disease, normally treated with chemotherapy and/or radiation. In addition, the researchers looked at three time periods: 1991-1995, 1996-1999, and 2000-2002.
Five-year survival rates were higher for whites (52.7 percent) than for blacks (47.5 percent) with stage I or II disease. For stage III and IV disease, 5-year survival rates were 17.7 percent for whites and 19.6 percent for blacks. When the researchers controlled for such things as treatment, socioeconomic status, and other factors, no significant differences were found in lung cancer mortality between blacks and whites in both groups. However, overall, blacks did have an increased risk for all-cause mortality. In addition, blacks with stage III and IV disease had an increased risk of mortality during 2000-2002. Blacks belonging to the lowest socioeconomic status category had an increased risk for all-cause mortality at all stages. They also had an increased risk for lung cancer mortality at stages III and IV. The study was supported in part by the Agency for Healthcare Research and Quality (HS16743).
See "Racial disparities and survival for nonsmall-cell lung cancer in a large cohort of black and white elderly patients," by Dale Hardy, Ph.D., Rui Xia, M.S., Chi-Chin Liu, M.S., and others in the October 15, 2009, Cancer, pp. 4807-4818.