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Thorac Cardiovasc Surg 2015; 63(07): 538-543
DOI: 10.1055/s-0035-1546295
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Racial and Ethnic Differences in Lung Cancer Surgical Stage: An STS Database Study

Benny Weksler
1   Division of Thoracic Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States
,
Andrzej S. Kosinski
2   Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, United States
,
William R. Burfeind
3   Division of Thoracic Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
,
Scott C. Silvestry
4   Department of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri, United States
,
Jennifer Sullivan
1   Division of Thoracic Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States
,
Thomas A. D'Amico
5   Division of Thoracic Surgery, Duke University Medical Center, Durham, North Carolina, United States
› Author Affiliations
Further Information

Publication History

17 August 2014

06 January 2015

Publication Date:
18 May 2015 (online)

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Abstract

Background Racial and ethnic differences in lung cancer care have been previously documented. These differences may be related to access to care, cultural differences, or fewer patients presenting with operable lung cancer. The relationship between race and pathologic stage of patients who undergo lung cancer resection has not been defined. This study estimates racial disparities in lung cancer stage among patients who undergo surgical resection.

Methods The Society of Thoracic Surgeons (STS) database was queried for patients who underwent resection of non-small cell lung cancer and had complete pathologic staging and racial identification. Univariate and multivariate analyses were performed. Study end point was the pathologic stage and we evaluated its association with the racial and ethnic origins of the patients.

Results Of 19,173 eligible patients with non-small cell lung cancer of known pathological stage who underwent surgery between 2002 and 2008, the majority were Caucasian (17,148, 89.4%), 1,502 (7.8%) were African–American, 273 (1.4%) were Asian, and 250 (1.3%) were Hispanic. In univariate analysis, significantly more Caucasian and African–American patients underwent resection of stage I/II lung cancer (13,929, 81.2% and 1,217, 81%, respectively) as compared with the Asian (207, 75.2%) and Hispanic (188, 75.8%) patients (p = 0.007). Stage at operation did not differ between Caucasians and African–Americans. Multivariate analysis confirmed these findings (p = 0.03) after adjustment for age, gender, tobacco use, diabetes, and year of surgery.

Conclusion Within the STS database, patients identified as Asian or Hispanic had a significantly higher pathologic stage at the time of resection than Caucasian or African–American patients. The causes of these differences in the treatment of potentially curable lung cancer are unknown and require further investigation.

Keywords

lung cancer surgery - lung cancer - database - STS general thoracic
 

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