Racial differences in the treatment of early-stage lung cancer
Racial differences in the treatment of early-stage lung cancer
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DOI：
10.1056/nejm199910143411606
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发表时间：
1999-10-14
影响因子：
158.5
通讯作者：
Begg, CB
中科院分区：
文献类型：
--
作者：
Bach, PB;Cramer, LD;Begg, CB
如果在早期发现，非小细胞肺癌有可能通过手术切除治愈。然而，黑人患者和白人患者之间存在两个差异。黑人比白人更不可能接受手术治疗，而且他们可能比白人死得早。我们进行了一项基于人群的研究，以估计手术治疗率的差异，并评估这种差异与总生存率差异的关联程度。方法：我们研究了1985年至1993年间被诊断为可切除的非小细胞肺癌（I期或II期）的所有65岁及以上的黑人患者和白人患者，这些患者居住在监测、流行病学和最终结果（SEER）项目的10个研究区域之一（10,984例患者）。患者的诊断、疾病分期、治疗和人口统计学特征数据均来自SEER数据库。从相关的医疗保险住院-出院记录中获得有关共存疾病、医疗保险覆盖类型和生存率的信息。结果黑人患者的手术率比白人患者低12.7个百分点(64.0%比76.7%，P
Background If discovered at an early stage, non-small-cell lung cancer is potentially curable by surgical resection. However, two disparities have been noted between black patients and white patients with this disease. Blacks are less likely to receive surgical treatment than whites, and they are likely to die sooner than whites. We undertook a population-based study to estimate the disparity in the rates of surgical treatment and to evaluate the extent to which this disparity is associated with differences in overall survival.Methods We studied all black patients and white patients 65 years of age or older who were given a diagnosis of resectable non-small-cell lung cancer (stage I or II) between 1985 and 1993 and who resided in 1 of the 10 study areas of the Surveillance, Epidemiology, and End Results (SEER) program (10,984 patients). Data on the diagnosis, stage of disease, treatment, and demographic characteristics of the patients were obtained from the SEER data base. Information on coexisting illnesses, type of Medicare coverage, and survival was obtained from linked Medicare inpatient-discharge records.Results The rate of surgery was 12.7 percentage points lower for black patients than for white patients (64.0 percent vs. 76.7 percent, P