Disparities in Lung Cancer Staging with Positron Emission Tomography in the Cancer Care Outcomes Research and Surveillance (CanCORS) Study

Michael K. Gould; M. Schultz Ellen; Todd H. Wagner; Xiangyan Xu; Sharfun J. Ghaus; Robert B. Wallace; Dawn Provenzale; David H. Au

doi:10.1097/JTO.0b013e31821671b6

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Disparities in Lung Cancer Staging with Positron Emission Tomography in the Cancer Care Outcomes Research and Surveillance (CanCORS) Study

Journal article

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Peer reviewed

Disparities in Lung Cancer Staging with Positron Emission Tomography in the Cancer Care Outcomes Research and Surveillance (CanCORS) Study

Michael K. Gould, M. Schultz Ellen, Todd H. Wagner, Xiangyan Xu, Sharfun J. Ghaus, Robert B. Wallace, Dawn Provenzale and David H. Au

Journal of thoracic oncology, Vol.6(5), pp.875-883

05/2011

DOI: 10.1097/JTO.0b013e31821671b6

PMCID: PMC3092472

PMID: 21572580

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Abstract

Disparities in treatment exist for nonwhite and Hispanic patients with non-small cell lung cancer, but little is known about disparities in the use of staging tests or their underlying causes. Prospective, observational cohort study of 3638 patients with newly diagnosed non-small cell lung cancer from 4 large, geographically defined regions, 5 integrated health care systems, and 13 VA health care facilities. Median age was 69 years, 62% were men, 26% were Hispanic or nonwhite, 68% graduated high school, 50% had private insurance, and 41% received care in the VA or another integrated health care system. After adjustment, positron emission tomography (PET) use was 13% lower among nonwhites and Hispanics than non-Hispanic whites (risk ratio [RR] 0.87, 95% confidence interval [CI] 0.77–0.97), 13% lower among those with Medicare than those with private insurance (RR 0.87, 95% CI 0.76–0.99), and 24% lower among those with an elementary school education than those with a graduate degree (RR 0.76, 95% CI 0.57–0.98). Disparate use of PET was not observed among patients who received care in an integrated health care setting, but the association between race/ethnicity and PET use was similar in magnitude across all other subgroups. Further analysis showed that income, education, insurance, and health care setting do not explain the association between race/ethnicity and PET use. Hispanics and nonwhites with non-small cell lung cancer are less likely to receive PET imaging. This finding is consistent across subgroups and not explained by differences in income, education, or insurance coverage.

Carcinoma

Emission-computed

Healthcare disparities

Lung neoplasms

Neoplasm staging

Non-small cell lung

Tomography

Details

Title: Subtitle: Disparities in Lung Cancer Staging with Positron Emission Tomography in the Cancer Care Outcomes Research and Surveillance (CanCORS) Study
Creators: Michael K. Gould - VA Palo Alto Health Care System
M. Schultz Ellen - Stanford University
Todd H. Wagner - VA Palo Alto Health Care System
Xiangyan Xu - Palo Alto Institute
Sharfun J. Ghaus - VA Palo Alto Health Care System
Robert B. Wallace - University of Iowa
Dawn Provenzale - Duke University
David H. Au - University of Washington
Resource Type: Journal article
Publication Details: Journal of thoracic oncology, Vol.6(5), pp.875-883
DOI: 10.1097/JTO.0b013e31821671b6
PMID: 21572580
PMCID: PMC3092472
NLM abbreviation: J Thorac Oncol
ISSN: 1556-0864
eISSN: 1556-1380
Publisher: Elsevier Inc
Language: English
Date published: 05/2011
Academic Unit: Epidemiology; Injury Prevention Research Center; Internal Medicine
Record Identifier: 9984363623502771

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