Social factors may affect survival in lung cancer patients

WINSTON-SALEM, N.C. - African Americans are more likely to develop and die from cancer than people of any other racial and ethnic group. A new study suggests that socioeconomic status and other social circumstances are likely to be responsible for decreased physical health at the time of diagnosis among African American patients with non-small-cell lung cancer.

The difference may explain disparities in survival rates between African American and non-African American patients who receive the same treatment for their cancer.

A. William Blackstock, M.D., of Wake Forest University School of Medicine, and colleagues within the Cancer and Leukemia Group B (CALGB) cooperative group, pooled data from five clinical trials of treatments for non-small-cell lung cancer and found that the one-year survival rate was 22 percent among African American patients and 30 percent among non-African American patients.

The data was analyzed to determine if the difference in survival rate was related to innate characteristics of the disease in the two populations or to disparities in health care. "We found that both groups of patients had similar stages of disease when they entered the trials. However, substantially more African American patients had a poorer ability to perform physical activity and had experienced weight loss with their disease," said Blackstock, assistant professor of radiation oncology. Both of these factors are known to decrease survival. Also, African American patients were more likely to be unmarried, to be uninsured or rely on Medicaid, and have a lower income.

"The results of this trial emphasize those factors that can lead to decreased performance ability and overall health and, thus, affect survival for all patients with advanced lung cancer," said Blackstock.

When statistical tests were performed to adjust for these social factors, there was no difference in outcome between the two ethnic groups. Thus, if social factors had b

Contact: Jonnie Rohrer
Wake Forest University Baptist Medical Center

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