Abstract C81: Variations in receipt of curative-intent surgery for early-stage non-small cell lung cancer (NSCLC) across states in the United States

Abstract

Abstract Background: Previous studies reported substantial racial and socioeconomic disparities in receipt of curative-intent surgery for early-stage non-small cell lung cancer (NSCLC) in the US. We examined variation in receipt of curative-intent surgery for early-stage non-small cell lung cancer (NSCLC) across states in the US. We also examined whether black/white disparity in receipt of curative-intent surgery varies by state. Methods: Patients with stage I or II NSCLC diagnosed in 2007–2011 were identified from 38 population-based cancer registries compiled by the North American Association of Central Cancer Registries (NAACCR). We calculated percentage for receipt of curative-intent surgery in each state. Adjusted risk ratios (RRs) were generated using modified Poisson regression to control for sociodemographic (e.g., age, sex, race, insurance) and clinical (e.g., grade, stage, tumor size) factors. NH whites and patients in Massachusetts used as reference for comparisons. Results: Receipt of curative-intent surgery for early-stage NSCLC varied substantially by state, ranging from 52.2% in Wyoming to about 75% in Massachusetts, New Jersey, and Utah. In a multivariable analysis, the likelihood of receiving curative-intent surgery for early-stage NSCLC patients was significantly lower in all states but seven states/registries and ranged from 7% lower in California (RR, 0.93; 95% CI, 0.89–0.97) to 25% lower in Wyoming (RR, 0.75; 95% CI, 0.59–0.95) compared with patients in Massachusetts. Receipt of curative-intent surgery was lower for NH black than NH white patients in all states though statistically significant in only two states (Florida, Texas) after accounting for differences in sociodemographic and clinical characteristics. Conclusions: Receipt of curative-intent surgery for early-stage NSCLC substantially varies across states in the United States, with the rate of receipt for both NH white and NH black patients generally lower and racial disparity higher in southern states. Citation Format: Helmneh M. Sineshaw, Xiao-Cheng Wu, W Dana Flanders, Raymond Uyiosa Osarogiagbon, Ahmedin Jemal. Variations in receipt of curative-intent surgery for early-stage non-small cell lung cancer (NSCLC) across states in the United States. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C81.