Racial Disparity and Social Determinants in Receiving Timely Surgery Among Stage I–IIIA Non-small Cell Lung Cancer Patients in a U.S. Southern State

Authors

Paige Neroda, Clemson University
Mei Chin Hsieh, LSU Health Sciences Center- New OrleansFollow
Xiao Cheng Wu, LSU Health Sciences Center- New OrleansFollow
Kathleen B. Cartmell, Clemson University
Rachel Mayo, Clemson University
Jiande Wu, LSU Health Sciences Center- New OrleansFollow
Chindo Hicks, LSU Health Sciences Center- New OrleansFollow
Lu Zhang, Clemson University

Document Type

Article

Publication Date

6-2-2021

Publication Title

Frontiers in Public Health

Abstract

Delayed surgery is associated with worse lung cancer outcomes. Social determinants can influence health disparities. This study aimed to examine the potential racial disparity and the effects from social determinants on receipt of timely surgery among lung cancer patients in Louisiana, a southern state in the U.S. White and black stage I–IIIA non-small cell lung cancer patients diagnosed in Louisiana between 2004 and 2016, receiving surgical lobectomy or a more extensive surgery, were selected. Diagnosis-to-surgery interval >6 weeks were considered as delayed surgery. Social determinants included marital status, insurance, census tract level poverty, and census tract level urbanicity. Multivariable logistic regression and generalized multiple mediation analysis were conducted. A total of 3,616 white (78.9%) and black (21.1%) patients were identified. The median time interval from diagnosis to surgery was 27 days in whites and 42 days in blacks (P < 0.0001). About 28.7% of white and 48.4% of black patients received delayed surgery (P < 0.0001). Black patients had almost two-fold odds of receiving delayed surgery than white patients (adjusted odds ratio: 1.91; 95% confidence interval: 1.59–2.30). Social determinants explained about 26% of the racial disparity in receiving delayed surgery. Having social support, private insurance, and living in census tracts with lower poverty level were associated with improved access to timely surgery. The census tract level poverty level a stronger effect on delayed surgery in black patients than in white patients. Tailored interventions to improve the timely treatment in NSCLC patients, especially black patients, are needed in the future.

First Page

1

Last Page

9

PubMed ID

34150706

Volume

9

Publisher

Frontiers Media

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Neroda, Paige; Hsieh, Mei Chin; Wu, Xiao Cheng; Cartmell, Kathleen B.; Mayo, Rachel; Wu, Jiande; Hicks, Chindo; and Zhang, Lu, "Racial Disparity and Social Determinants in Receiving Timely Surgery Among Stage I–IIIA Non-small Cell Lung Cancer Patients in a U.S. Southern State" (2021). School of Medicine Faculty Publications. 70.
https://digitalscholar.lsuhsc.edu/som_facpubs/70
10.3389/fpubh.2021.662876

File Format

pdf

File Size

440 KB