Dissecting racial/ethnic disparities in non-small cell lung cancer staging at diagnosis: Intra-ethnic and geographic differences.

Abstract

1575 Background: Lung cancer outcomes significantly rely on accurate and early detection. This population-based study aims to identify factors contributing to disparities in the stage of non-small cell lung cancer (NSCLC) diagnoses, focusing on Hispanic ethnic subgroups. Methods: Incident cases diagnosed from 2005–2018 were extracted from the Florida State Cancer Registry. Stage was categorized as resectable (Stage I-IIIA) or nonresectable (Stage IIIB/IIIC/IV) NSCLC. Multivariable logistic regression models were used to assess the association between race/ethnicity and stage at diagnosis, adjusted for socioeconomic, smoking status, and clinical factors. Regional stratification involved separate analyses for heavily Hispanic South Florida and the rest of Florida. Results: Among 157,034 NSCLC patients, with a racial distribution of 81.0% White, 8.3% Black, and 9.2% Hispanic, 43.2% were diagnosed at a resectable stage. Age-adjusted models showed Black patients had 22% higher odds (odds ratio [OR]=1.22; 95% CI: 1.21-1.23) and Hispanic patients had 11% higher odds (OR=1.11; 95% CI: 1.10-1.12) of non-resectable stage across all subgroups diagnoses compared to White patients. However, after further adjustment, higher odds were significant only for NHB (ORadj=1.12; 95% CI: 1.11-1.14) and Central American Hispanics (ORadj=1.41; 95% CI: 1.35-1.47). Regional differences were significant, with Hispanic patients in South Florida showing more favorable staging outcomes than Whites (ORadj=0.95; 95% CI: 0.94-0.97), while in the rest of Florida, Hispanic patients were at a disadvantage (ORadj=1.09; 95% CI: 1.07-1.10). Conclusions: Pronounced NSCLC staging disparities are manifest in Black and Hispanic populations, coupled with striking regional variations among Florida's Hispanic groups which underscores the necessity for targeted research to dissect and address the underlying causes of these inequities in the cancer care continuum.