Racial Disparities in Receipt of Lung Cancer Treatment in Southwest Georgia Public

Abstract

Abstract
Racial Disparities in Receipt of Lung Cancer Treatment in Southwest Georgia

Background: Previous studies have revealed existing racial disparities in the receipt of
treatment among different groups of lung cancer patients in large urban settings. This study
aims at evaluating lung cancer treatment patterns in a primarily rural region - Southwest
Georgia (SWGA).
Methods: This population-based retrospective cohort study included 976 black and white
lung cancer patients who resided in SWGA and were diagnosed from 2001 to 2003. Cases
were identified through Georgia Cancer Registry (GCR). Patient-/disease-related
characteristics, and treatment relevant data were obtained directly from medical records. We
used logistic regression modeling to calculated crude and adjusted odds ratios (ORs) and the
corresponding 95% confidence intervals (CIs) reflecting the association between various
patient- and disease-related characteristics and receipt of treatment for lung cancer (surgery,
radiation, chemotherapy). A separate analysis was conducted to evaluate determinants of
receiving no treatment at al .
Results: No statistically significant associations were observed between race (Black versus
White) and treatment receipt among SWGA lung cancer patients with OR of 0.64 (95% CI:
0.39-1.06) for surgery, OR=0.84 (95% CI: 0.62-1.14) for radiation, OR=0.64 (95% CI: 0.43-
0.96) for chemotherapy. Older patients had a statistically significantly lower likelihood of
receiving treatment in al analyses. Married individuals were more likely to receive any kind
of treatment compared with those not married (single, separated, divorced, or widowed).
Patients with earlier stage of lung cancer were also more likely to receive surgery but were
less likely to receive radiation and chemotherapy or have no treatment at al .
Conclusion: Our findings confirmed previous reports indicating that marital status and age
are important determinants of treatment receipt among lung cancer patients. No racial
differences were observed in this largely rural region, which is consistent with our earlier
observations in the SWGA population. Further investigations are needed in both SWGA
and other rural areas of the country to extend the analysis beyond treatment receipt, and to
evaluate predictors of treatment completion and survival among lung cancer patients.

Table of Contents

Table of Contents
INTRODUCTION

................................................................................................................... - 1 -
METHODS ............................................................................................................................. - 3 -
RESULTS ............................................................................................................................... - 7 -
DISCUSSION ........................................................................................................................ - 12 -
REFERENCES ...................................................................................................................... - 17 -
TABLES ............................................................................................................................... - 22 -
Table 1 Non-Small Cell Lung Cancer (NSCLC), Treatment Options by Stage ........................ - 22 -
Table 2 Small Cell Lung Cancer (SCLC), Treatment Options by Stage .................................. - 23 -
Table 3 Characteristics of participants diagnosed with lung cancer in SWGA, 2001-2003. .. - 24 -
Table 4 Multivariable Logistic Regression Analysis of the Association between Treatment
Modality and Characteristics of Study Participants ............................................................ - 26 -
FIGURES .............................................................................................................................. - 28 -
Figure 1 Lung cancer patients diagnosed and treated in SWGA, 2001-2003: Receipt of
different kinds of treatments in our study population. ...................................................... - 28 -

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Mot-clé	Lung Cancer Southwest Georgia Treatment receipt rural area
Committee Chair / Thesis Advisor	Goodman, Michael, Emory University
Partnering Agencies	Georgia state or local agency (not a health department) CDC

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