Neighborhood context and non-small cell lung cancer outcomes in Florida non-elderly patients by race/ethnicity

Johnson, Asal M.; Johnson, A. C.; Hines, Rebecca; Mohammadi, Raheleh

doi:10.1016/j.lungcan.2020.01.012

Cited by 14 publications

(5 citation statements)

References 37 publications

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“… 71 Rural residence and being part of a VSG also appear linked to limited treatment access 51–56 including access to timely and appropriate care. 58 59 72 Multiple studies demonstrated the negative impact of deprivation on access to surgery, 48 60 61 73 a finding consistent with previous work which found that low socioeconomic position reduced the likelihood of receipt of any type of LC treatment, surgery or chemotherapy. 21 …”

Section: Discussionsupporting

confidence: 82%

“… 47 Another found LC outcomes are impacted by neighbourhood environments that are shaped by distribution of race, ethnicity and class. 48 Finally, Erhunmwunsee et al explored the relationship between poverty/median income and higher educational attainment and concluded these indicators were highly correlated: those living in areas with higher percentages of residents achieving higher education having improved LC outcomes. 73 …”

Section: Discussionmentioning

confidence: 99%

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What health inequalities exist in access to, outcomes from and experience of treatment for lung cancer? A scoping review

Lennox,

Lambe,

Hindocha

et al. 2023

BMJ Open

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ObjectivesLung cancer (LC) continues to be the leading cause of cancer-related deaths and while there have been significant improvements in overall survival, this gain is not equally distributed. To address health inequalities (HIs), it is vital to identify whether and where they exist. This paper reviews existing literature on what HIs impact LC care and where these manifest on the care pathway.DesignA systematic scoping review based on Arksey and O’Malley’s five-stage framework.Data sourcesMultiple databases (EMBASE, HMIC, Medline, PsycINFO, PubMed) were used to retrieve articles.Eligibility criteriaSearch limits were set to retrieve articles published between January 2012 and April 2022. Papers examining LC along with domains of HI were included. Two authors screened papers and independently assessed full texts.Data extraction and synthesisHIs were categorised according to: (a) HI domains: Protected Characteristics (PC); Socioeconomic and Deprivation Factors (SDF); Geographical Region (GR); Vulnerable or Socially Excluded Groups (VSG); and (b) where on the LC pathway (access to, outcomes from, experience of care) inequalities manifest. Data were extracted by two authors and collated in a spreadsheet for structured analysis and interpretation.Results41 papers were included. The most studied domain was PC (32/41), followed by SDF (19/41), GR (18/41) and VSG (13/41). Most studies investigated differences in access (31/41) or outcomes (27/41), with few (4/41) exploring experience inequalities. Evidence showed race, rural residence and being part of a VSG impacted the access to LC diagnosis, treatment and supportive care. Additionally, rural residence, older age or male sex negatively impacted survival and mortality. The relationship between outcomes and other factors (eg, race, deprivation) showed mixed results.ConclusionsFindings offer an opportunity to reflect on the understanding of HIs in LC care and provide a platform to consider targeted efforts to improve equity of access, outcomes and experience for patients.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

What health inequalities exist in access to, outcomes from and experience of treatment for lung cancer? A scoping review

Lennox,

Lambe,

Hindocha

et al. 2023

BMJ Open

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“…The present study's findings might not be applicable to countries without a universal health insurance system. For example, American lung cancer patients living in high deprivation areas have lower rates of surgical treatment (19). In addition, stage I-III non-small cell lung cancer patients are more likely to receive timely treatment at a private hospital than at a public hospital (20), and uninsured status is also associated with a lower initial treatment rate for small cell lung cancer in the US (8).…”

Section: Discussionmentioning

confidence: 99%

Influence of loneliness and social isolation on the diagnosis and treatment of Japanese patients with advanced lung cancer: a prospective cohort study

Takemura¹,

Kataoka

Shirakawa

et al. 2021

Ann Palliat Med

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Background: Social determinants of health (SDHs) are social factors that affect human health; loneliness and social isolation are core SDH factors. There is a possibility that SDHs are related to passive decisionmaking. However, few studies have evaluated SDHs, especially social isolation and loneliness, among lung cancer patients. This study aims to investigate the effects of social isolation and loneliness on the diagnosis and treatment of Japanese lung cancer patients.Methods: This is a prospective cohort study that was conducted in a tertiary referral hospital in Japan (University Hospital Medical Information Network registration: UMIN000031810). The enrollment period was between April 2018 and March 2020. Patients with clinical and/or pathological diagnosis of lung cancer were enrolled in this study. Exposures were social isolation and loneliness, and main outcomes were diagnosis methods and whether the initial treatment involved active therapy or best supportive care (BSC). The confounding factors were defined as sex, age, smoking status, respiratory symptoms, weight loss, presentation with any symptoms, Eastern Cooperative Oncology Group (ECOG) performance status, tumor nodes metastasis (TNM) classification, driver gene mutations [i.e., epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK)], and programmed death-ligand 1 (PD-L1) tumor proportion score. Results:The study enrolled 264 patients who were divided into quartiles according to their loneliness scores and into two groups according to the social isolation level. Univariate analysis, complete case analysis, and multivariate analysis with multiple imputation failed to detect significant differences in diagnostic method or initial treatment strategy according to loneliness or social isolation level.Conclusions: Physicians may not need to consider a patient's loneliness and/or social isolation when diagnosing lung cancer and selecting treatment under universal health insurance coverage. Further studies are needed to understand the influences of loneliness and social isolation on the prognosis of lung cancer patients. 2 Takemura et al. Social health determinants of Japanese lung cancer patients

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“…These barriers and access challenges contribute to worsening survival rates for rural/small-town patients compared to urban/metro counties at 1 year (85% vs. 87%), 5 years (48% vs. 54%), and 10 years (26% vs. 31%) ( 78 ). In general, lung cancer mortality rates are higher among all rural racial/ethnic groups vs. urban (e.g., 54% higher for AA/B) ( 79 ). This makes it critical for rural populations to have access to palliative care end-of-life options, however, patients who reside in rural areas are at an increased risk for underutilizing palliative care ( 80 ), presumably because of palliative care provider scarcity.…”

Section: Ruralmentioning

confidence: 99%

Health inequities across the lung cancer care continuum in ten marginalized populations: a narrative review

Monestime,

Rigney,

Phipps

et al. 2023

J Thorac Dis

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Background and Objective Lung cancer remains the deadliest cancer in the United States. Although lung cancer screening and innovative treatment options are available, accessing these interventions remains a barrier for marginalized communities due to social and structural challenges that influence health care access, which has led to worse outcomes when compared to Non-Hispanic Whites (NHW) and non-marginalized populations. The objective of this study is to examine disparities in lung cancer and social/structural factors within ten critical populations (racial/ethnic minorities, low income, rural, LGBTQIA+, women, veteran and active duty, and small cell lung cancer) across the continuum of lung cancer care. Methods Five databases (PubMed, the Cochrane Library, EMBASE, Web of Knowledge, and EBSCO Discovery Service) were queried from February 2022–June 2022. The inclusion criteria were (I) peer-reviewed academic journals published in English between the years 2000 and 2022; (II) research that focused on disparities across the lung cancer continuum; and (III) research articles addressing social and structural barriers to lung cancer health care access. A total of 95 articles and 24 reports were used for this narrative review. Key Content and Findings Across the ten populations, consistent disparities were observed in lung cancer screening and treatment, exhibited by lower uptake in screening, treatment, clinical trials, and biomarker testing. Significant themes contributing to these disparities were socioeconomic status, transportation, language, historic trauma, provider bias or lack of cultural training, and lack of health care access, in part due to insurance coverage. Conclusions Future studies are needed to further develop meaningful solutions to disparities in health outcomes and access for those who are at risk, diagnosed with, or surviving lung cancer from marginalized populations.

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Neighborhood context and non-small cell lung cancer outcomes in Florida non-elderly patients by race/ethnicity

Cited by 14 publications

References 37 publications

What health inequalities exist in access to, outcomes from and experience of treatment for lung cancer? A scoping review

What health inequalities exist in access to, outcomes from and experience of treatment for lung cancer? A scoping review

Influence of loneliness and social isolation on the diagnosis and treatment of Japanese patients with advanced lung cancer: a prospective cohort study

Health inequities across the lung cancer care continuum in ten marginalized populations: a narrative review

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