Minority patients with nonsmall-cell lung cancer are less likely to receive hospice services than whites
Research Activities September 2011, No. 373
There are substantial racial and ethnic disparities in the receipt of hospice care among elderly patients with advanced nonsmall-cell lung cancer (NSCLC), according to a new study. Patients diagnosed with late-stage NSCLC have a 5-year survival rate of only 2.8 percent. Patients who are not likely to benefit from curative treatment can enroll in hospice care instead, with the goal of living an alert, pain-free last months with dignity, according to the researchers. They retrospectively studied elderly patients diagnosed with advanced-stage NSCLC (107,149 urban residents and 10,745 rural residents). Among the urban residents, when the researchers compared whites with minority patients, the latter were from 19-58 percent less likely to receive hospice care. For patients living in rural areas, blacks (but not Asians/Pacific Islanders or Hispanics) had a significant 21 percent lower rate of hospice care than whites.
The difference in services when compared with whites was found for blacks and Asians/Pacific Islanders across all income quartiles, but only in the two lowest socioeconomic quartiles for Hispanics. Regardless of income level, women were 30-34 percent more likely to receive hospice care than men, and patients over 69 years old were 7-26 percent more likely to receive hospice care than those 66-69 years. Finally, patients diagnosed after 1995 were more likely to receive hospice care than those diagnosed between 1991 and 1995.
The study's findings were based on linked data from the National Cancer Insitute's Surveillance, Epidemiology, and End Results registries and Medicare regarding patients over age 65, who died from NSCLC between January 1991 and December 2005. The study was funded in part by the Agency for Healthcare Research and Quality (HS16743).
More details are in "Racial disparities in the use of hospice services according to geographic residence and socioeconomic status in elderly cohort with nonsmall cell lung cancer," by Dale Hardy, Ph.D., Wenyaw Chan, Ph.D., Chih-Chin Liu, M.S., and others in the April 1, 2011, Cancer 117(7), pp. 1506-1515.