Abstract A023: Racial differences in lung cancer burden: A retrospective analysis of TriNetX data

Abstract

Abstract Background. Lung cancer is the number one cause of cancer-related deaths in the U.S. and many other countries. Lung cancer incidence and mortality rates have decreased for all races over the past 20 years, in part because of decreased tobacco use. Yet, there have been few clinical studies of lung cancer morbidity and mortality by race. The purpose of this study is to examine racial differences in lung cancer mortality in the U.S. using the electronic health records (EHR) database, TriNetX. Method. This retrospective cohort study was conducted based on the data from US Collaborative Network in TriNetX, a real-time, EHR database providing 42.7-million patient data from 49 health care organizations (HCOs). The cohort of interest was lung cancer patients in the U.S., which were identified using the ICD-10 code of C34 with an index diagnosis date of January 1, 2010. Kaplan-Meier curves, log-rank chi-square statistics, and hazard ratio (HR) were compared among different racial groups in the EHR data. Results. Of 42.7-million patients in the U.S., the majority (60.3%) were people who are non-Hispanic white (NHW) followed by people who are Black/African American (15.4%), Hispanic (7.2%), Asian (4.6%), and others (Native Hawaiian/Pacific Islander, 0.5%). 394,560 lung cancer patients were identified. Kaplan-Meier survival curves showed that Asians had the highest survival probability with median overall survival (OS) from the initial lung cancer diagnosis of 127.3 months, compared to 92.1 months for Hispanic, 69.1 months for African American/Black, 61.4 months for others, and 53.8 months for NHW. The HR was highest among NHW (HR=1.71, 95% CI=1.62-1.81), others (HR=1.62, 95% CI=1.41-1.85), African American/Black (HR=1.52, 95% CI=1.43-1.61), and Hispanic patients (HR=1.40, 95% CI=1.30-1.52) compared to Asian patients Conclusion. These findings suggest racial disparities in lung cancer survival, with NHW having the lowest and Asians having the highest median survival. These findings are inconsistent with the results from the Multiethnic Cohort study (prospective population based study), which reported blacks having the lowest median survival. It indicates that there are different racial burdens of lung cancer from clinical data and population data. Further analyses are needed to adjust potential confounders such as smoking status and stage of diagnosis. Citation Format: SoHye Park, Zachary Urdang, Julie Barta, Kuang-Yi Wen, Joseph Curry, Hee-Soon Juon. Racial differences in lung cancer burden: A retrospective analysis of TriNetX data [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A023.