מתוך medicontext.co.il
NEW YORK (Reuters Health) – Social rather than disease factors are probably to blame for the lower survival rates among African Americans with advanced non-small-cell lung carcinoma (NSCLC) than in other racial groups.
Dr. A. William Blackstock, from Wake Forest University in Winston-Salem, North Carolina, and colleagues compared the outcomes of 46 African-American and 458 non-African-American patients with advanced NSCLC who were treated with similar systemic therapy regimens.
The 1-year survival rate for African-American patients was 22% compared with 30% for non-African-American patients (p = 0.03), the authors report in the February 20th issue of the Journal of the National Cancer Institute. Furthermore, adjusting for treatment arm, histology, and metastatic site at presentation did not alter the observed difference in survival.
When the researchers controlled for performance status and weight loss, however, the racial disparity disappeared. Analysis revealed that African-American patients were more likely to present with a poor performance status and substantial weight loss than non-African-American patients. In addition, African-American patients were more likely to be unmarried, disabled, unemployed, and Medicaid recipients.
"There have been some inferences in the literature that lung cancer is more aggressive in African Americans than in other groups," Dr. Blackstock told Reuters Health. "But, I've never really bought into that," he added. "The current findings support this and show that it is probably social factors that lead to a difference in outcomes."
Dr. Blackstock noted that "the results indicate that African Americans with lung cancer are presenting later" in the disease process. "For whatever reason, they are entering the healthcare system later than other groups," he said.
"We spend so much time testing different treatments, but if we can just get patients plugged into the healthcare system it can make all the difference in the world," Dr. Blackstock emphasized. He noted that his team is planning to conduct interventional studies to determine the best method of improving access to healthcare for African Americans with lung cancer.
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