In a national population-based study of 16,036 lung cancer patients, Hispanics with curable stage I lung cancer had poorer lung cancer specific survival rates, as well as worse all-cause mortality, than a much larger group of white persons. Study results will appear in the second issue for May 2005 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.
Juan P. Wisnivesky, M.D., M.P.H., of the Department of Medicine at Mount Sinai School of Medicine in New York City, New York, along with five associates, noted that the disparities between the two ethnic groups were largely explained by lower rates of surgical resection among the Hispanics and higher probability of diagnosis at the more advanced IB stage for lung cancer.
"Lung cancer is the leading cause of death among Hispanic men and the second leading cause of death among Hispanic women," said Dr. Wisnivesky. "Meaningful long-term survival, unfortunately, is only possible with non-small cell lung cancer cases diagnosed at an early stage and treated with surgical resection. Patients with surgically resected stage I lung cancer have at least a 65 percent probability of surviving 5 years or longer. Conversely, patients with early stages of lung cancer who do not undergo resection have a median survival of less than 2 years."
In the study, of the 16,036 eligible patients with stage I primary, non-small cell lung cancer, 686 (4.3 percent) were Hispanics and 15,350 (95.7 percent) were white. The five-year lung cancer survival rate was 54 percent for Hispanics versus 62 percent for whites. Also, Hispanics were more frequently diagnosed with later stage lung cancer IB.
Other factors also significantly associated with lung cancer death in this study were older age, not being married, having stage IB disease and a lower mean per capita income.
"However, our multivariate analyses suggest that most of the unadjusted difference in survival can be explained by unequal rates of surgical resection and differences in the proportion of patients presenting with stage IB disease," said Dr. Wisnivesky.
The investigators said that their future research would explore why Hispanics are less likely to undergo resection and more likely to be diagnosed at the advanced stage.
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