Racial and Ethnic Differences in Lung Cancer Surgical Stage

An STS Database Study

Benny Weksler, Andrzej S. Kosinski, William R. Burfeind, Scott C. Silvestry, Jennifer Sullivan, Thomas A. D'Amico

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Racial and ethnic differences in lung cancer care have been previously documented. These differences may be related to access to care, cultural differences, or fewer patients presenting with operable lung cancer. The relationship between race and pathologic stage of patients who undergo lung cancer resection has not been defined. This study estimates racial disparities in lung cancer stage among patients who undergo surgical resection. Methods The Society of Thoracic Surgeons (STS) database was queried for patients who underwent resection of non-small cell lung cancer and had complete pathologic staging and racial identification. Univariate and multivariate analyses were performed. Study end point was the pathologic stage and we evaluated its association with the racial and ethnic origins of the patients. Results Of 19,173 eligible patients with non-small cell lung cancer of known pathological stage who underwent surgery between 2002 and 2008, the majority were Caucasian (17,148, 89.4%), 1,502 (7.8%) were African-American, 273 (1.4%) were Asian, and 250 (1.3%) were Hispanic. In univariate analysis, significantly more Caucasian and African-American patients underwent resection of stage I/II lung cancer (13,929, 81.2% and 1,217, 81%, respectively) as compared with the Asian (207, 75.2%) and Hispanic (188, 75.8%) patients (p = 0.007). Stage at operation did not differ between Caucasians and African-Americans. Multivariate analysis confirmed these findings (p = 0.03) after adjustment for age, gender, tobacco use, diabetes, and year of surgery. Conclusion Within the STS database, patients identified as Asian or Hispanic had a significantly higher pathologic stage at the time of resection than Caucasian or African-American patients. The causes of these differences in the treatment of potentially curable lung cancer are unknown and require further investigation.

Original languageEnglish (US)
Pages (from-to)538-543
Number of pages6
JournalThoracic and Cardiovascular Surgeon
Volume63
Issue number7
DOIs
StatePublished - May 18 2015

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Lung Neoplasms
Thorax
Databases
African Americans
Hispanic Americans
Non-Small Cell Lung Carcinoma
Multivariate Analysis
Surgeons
Tobacco Use

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Weksler, B., Kosinski, A. S., Burfeind, W. R., Silvestry, S. C., Sullivan, J., & D'Amico, T. A. (2015). Racial and Ethnic Differences in Lung Cancer Surgical Stage: An STS Database Study. Thoracic and Cardiovascular Surgeon, 63(7), 538-543. https://doi.org/10.1055/s-0035-1546295

Racial and Ethnic Differences in Lung Cancer Surgical Stage : An STS Database Study. / Weksler, Benny; Kosinski, Andrzej S.; Burfeind, William R.; Silvestry, Scott C.; Sullivan, Jennifer; D'Amico, Thomas A.

In: Thoracic and Cardiovascular Surgeon, Vol. 63, No. 7, 18.05.2015, p. 538-543.

Research output: Contribution to journalArticle

Weksler, B, Kosinski, AS, Burfeind, WR, Silvestry, SC, Sullivan, J & D'Amico, TA 2015, 'Racial and Ethnic Differences in Lung Cancer Surgical Stage: An STS Database Study', Thoracic and Cardiovascular Surgeon, vol. 63, no. 7, pp. 538-543. https://doi.org/10.1055/s-0035-1546295
Weksler, Benny ; Kosinski, Andrzej S. ; Burfeind, William R. ; Silvestry, Scott C. ; Sullivan, Jennifer ; D'Amico, Thomas A. / Racial and Ethnic Differences in Lung Cancer Surgical Stage : An STS Database Study. In: Thoracic and Cardiovascular Surgeon. 2015 ; Vol. 63, No. 7. pp. 538-543.
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N2 - Background Racial and ethnic differences in lung cancer care have been previously documented. These differences may be related to access to care, cultural differences, or fewer patients presenting with operable lung cancer. The relationship between race and pathologic stage of patients who undergo lung cancer resection has not been defined. This study estimates racial disparities in lung cancer stage among patients who undergo surgical resection. Methods The Society of Thoracic Surgeons (STS) database was queried for patients who underwent resection of non-small cell lung cancer and had complete pathologic staging and racial identification. Univariate and multivariate analyses were performed. Study end point was the pathologic stage and we evaluated its association with the racial and ethnic origins of the patients. Results Of 19,173 eligible patients with non-small cell lung cancer of known pathological stage who underwent surgery between 2002 and 2008, the majority were Caucasian (17,148, 89.4%), 1,502 (7.8%) were African-American, 273 (1.4%) were Asian, and 250 (1.3%) were Hispanic. In univariate analysis, significantly more Caucasian and African-American patients underwent resection of stage I/II lung cancer (13,929, 81.2% and 1,217, 81%, respectively) as compared with the Asian (207, 75.2%) and Hispanic (188, 75.8%) patients (p = 0.007). Stage at operation did not differ between Caucasians and African-Americans. Multivariate analysis confirmed these findings (p = 0.03) after adjustment for age, gender, tobacco use, diabetes, and year of surgery. Conclusion Within the STS database, patients identified as Asian or Hispanic had a significantly higher pathologic stage at the time of resection than Caucasian or African-American patients. The causes of these differences in the treatment of potentially curable lung cancer are unknown and require further investigation.

AB - Background Racial and ethnic differences in lung cancer care have been previously documented. These differences may be related to access to care, cultural differences, or fewer patients presenting with operable lung cancer. The relationship between race and pathologic stage of patients who undergo lung cancer resection has not been defined. This study estimates racial disparities in lung cancer stage among patients who undergo surgical resection. Methods The Society of Thoracic Surgeons (STS) database was queried for patients who underwent resection of non-small cell lung cancer and had complete pathologic staging and racial identification. Univariate and multivariate analyses were performed. Study end point was the pathologic stage and we evaluated its association with the racial and ethnic origins of the patients. Results Of 19,173 eligible patients with non-small cell lung cancer of known pathological stage who underwent surgery between 2002 and 2008, the majority were Caucasian (17,148, 89.4%), 1,502 (7.8%) were African-American, 273 (1.4%) were Asian, and 250 (1.3%) were Hispanic. In univariate analysis, significantly more Caucasian and African-American patients underwent resection of stage I/II lung cancer (13,929, 81.2% and 1,217, 81%, respectively) as compared with the Asian (207, 75.2%) and Hispanic (188, 75.8%) patients (p = 0.007). Stage at operation did not differ between Caucasians and African-Americans. Multivariate analysis confirmed these findings (p = 0.03) after adjustment for age, gender, tobacco use, diabetes, and year of surgery. Conclusion Within the STS database, patients identified as Asian or Hispanic had a significantly higher pathologic stage at the time of resection than Caucasian or African-American patients. The causes of these differences in the treatment of potentially curable lung cancer are unknown and require further investigation.

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