Abstract PO-114: Disparities in care among patients undergoing treatment for Non-Small Cell Lung Cancer in a safety net hospital

Abstract

Abstract Background: Treatment of patients (pts) with Non-Small Cell Lung Cancer (NSCLC) has changed tremendously in the last few years, however, the impact of these new therapies has been uneven; with socioeconomic, ethnic and access differences impacting the quality and outcomes experienced across pts. Methods: We identified 5,722 pts at a Safety Net Hospital system in Indianapolis, Indiana who had been diagnosed with NSCLC using ICD 9 and ICD 10 codes from 2015 to 2019 and received surgery for it. We identified possible SCLC miscoded cases by identifying and removing a priori patients who received either etoposide or irinotecan. Data was collated and analyzed using descriptive statistics and Chi-square tests through STATA software. Results: Among the 5,722 patients who underwent surgery, 69.9% pts were female(F), 49.6% pts identified as Black (B), 50.0% identified as non-Hispanic white (NHW) and 0.4% as Hispanic (H). BF made up 63.7% of all B pts, and NHW F made up 76.9% of all NHW pts. Given the low rates of H pts, we did not include them in further analysis. B pts were more likely to be uninsured (66.6%). B pts were more likely to be referred to tumor board (86.4% vs 13.5%; p-value<0.01) and less likely to be referred to radiation oncology (42.5% vs 55.9%; p-value <0.01). Rates of Brain MRI were higher among NHW pts (81.3% vs 18.4%, p-value<0.01); inversely PET CT rates were lowest among NHW pts (47.1% vs 52.9%, p-value<0.01). Among patients who underwent surgery, NHW were more likely to have received cisplatin compared to Blacks (32.08% vs 1.2%; p-value<0.01) and among all patients who received surgery and received cisplatin, 98.3% received it in the neoadjuvant setting, 1.4% within 60 days post-op and 0.4% after 60 days post-op. NHW pts were more likely to receive neoadjuvant cisplatin compared to Blacks (97.2% vs 2.8%; p-value<0.01) and B pts were more likely to receive adjuvant cisplatin both within 60 days (30.4%) and more than 60 days after surgery (8.7%). Unfortunately given limitations in data extractions, we were not able to determine histology or stage at diagnosis in our cohort. Conclusions: This large single-institution study in a safety-net hospital notes tendencies among NSCLC patients; higher rates of prevalence among F, as well as higher rates of uninsured status and less use of Brain MRI and Radiation Oncology Referrals among B pts. Among patients who underwent surgery NHW were more likely to receive cisplatin. These differences might be due to socioeconomic status, access to care or patient-dependent factors such as stage at diagnosis. Further investigation is needed to adequately identify and address these disparities. Citation Format: Manuel R. Espinoza Gutarra, Oindrila Bhattacharyya, David Haggstrom. Disparities in care among patients undergoing treatment for Non-Small Cell Lung Cancer in a safety net hospital [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-114.