Social Factors, Treatment, and Survival in Early-Stage Non-Small Cell Lung Cancer

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Abstract

Objectives

This study assessed the importance of socioeconomic status, race, and likelihood of receiving surgery in explaining mortality among patients with stage-I non-small cell lung cancer.

Methods

Analyses focused on Black and White individuals 75 years of age and younger (n = 5189) diagnosed between 1980 and 1982 with stage-I non-small cell lung cancer in Detroit, San Francisco, and Seattle, The main outcome measure was months of survival after diagnosis.

Results

Patients in the highest income decile were 45% more likely to receive surgical treatment and 102% more likely to attain 5-year survival than those in the lowest decile. Whites were 20% more likely to undergo surgery than Blacks and 31% more likely to survive 5 years. Multivariate procedures controlling for age and sex confirmed these observations.

Conclusions

Socioeconomic status and race appear to independently influence likelihood of survival. Failure to receive surgery explains much excess mortality. (Am J Public Health. 1998;88:1681-1684)

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