Study Finds Racial Disparities in Lung Cancer Treatment

Black patients with treatable lung cancer are less likely to undergo comprehensive diagnostic procedures and surgery than white patients with the same severity of the disease, regardless of whether they have similar access to specialized medical care, according to a study scheduled to appear on Jan. 20 in the Journal of Clinical Oncology, the New York Times reports. For the study -- led by Christopher Lathan, an instructor of medicine at Harvard Medical School -- researchers examined 21,219 patients older than age 65 with treatable non-small-cell lung cancer.

Researchers used data from 11 tumor registries established in a previous nationwide study. According to the new study, about 14,000 participants underwent invasive procedures to determine the form and severity of their cancer, and black participants were 75% as likely as white participants to undergo such procedures.

In addition, among participants who underwent such procedures, black participants were more than half as likely as white participants to undergo surgery, the study finds. The results of the study remained consistent when researchers controlled for age, severity of cancer and other diseases.

Health coverage and the ability to pay were not factors in the study because Medicare covered costs for all participants.

Lathan said of the racial disparities identified in the study, "In our society, it is always hard to rule out racism." However, he added, "Most doctors want the right thing for folks. The way a physician communicates and what he expects weigh heavily. And we haven't looked at that. It's a complex situation. It's not just conscious or unconscious racism."

Lathan said, "The major point is that African-American patients are still getting surgery less often than white patients. There is something happening here that is more than access to care."

Researchers also attributed the racial disparities identified in the study to lack of access to care, low-quality primary care and mistrust of the health care system among black participants.

John Stewart, an assistant professor of surgery at Wake Forest University who was not involved in the study, said, "An underlying implication of this work is that the well-documented disparity in survival from lung cancer in African-American patients can be directly attributable to inadequacies in diagnosis, staging and therapy" (Bakalar, New York Times, 1/3).

The study is available online. Note: You must have Adobe Acrobat Reader to view the study.