Socioeconomic Factors Associated with Lack of Treatment in Early Stage Non-Small Cell Lung Cancer

Cancer Invest. 2019;37(9):506-511. doi: 10.1080/07357907.2019.1666136. Epub 2019 Sep 18.

Abstract

With modern radiotherapy, stage I non-small cell lung cancer (S1NSCLC) cure is extended to nonsurgical candidates. Despite this, some S1NSCLC remains untreated. We aim to identify factors associated with no treatment. 62,213 S1NSCLC cases were identified (SEER: 2004-2012). Demographics were compared using Chi-squared. Multivariate analysis was performed using COX proportional HR. 11.9% of the 7373 patients lacked treatment. No insurance, Medicaid-dependence, unmarried status, advancing age, lower income, African American and Asian/Pacific Islander race, and male sex are associated with no treatment (p < .0001). No treatment portends a worse cancer-specific survival (21% vs 66% at 5Y, p < .0001) and OS (10% vs 50% at 5Y, p < .0001).

Keywords: Lung cancer; access to care; radiation; socioeconomic; surgery.

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / ethnology
  • Carcinoma, Non-Small-Cell Lung / pathology*
  • Female
  • Humans
  • Lung Neoplasms / ethnology
  • Lung Neoplasms / pathology*
  • Male
  • Medicaid
  • Middle Aged
  • Neoplasm Staging
  • Proportional Hazards Models
  • SEER Program
  • Socioeconomic Factors
  • Survival Rate
  • United States / ethnology
  • Watchful Waiting / statistics & numerical data*