Social factors, treatment, and survival in early-stage non-small cell lung cancer.
OBJECTIVE
This study assessed the importance of socioeconomic status, race, and likelihood of receiving surgery in explaining mortality among patients with stage-I non-small cell lung cancer.


METHODS
Analyses focused on Black and White individuals 75 years of age and younger (n = 5189) diagnosed between 1980 and 1982 with stage-I non-small cell lung cancer in Detroit, San Francisco, and Seattle. The main outcome measure was months of survival after diagnosis.


RESULTS
Patients in the highest income decile were 45% more likely to receive surgical treatment and 102% more likely to attain 5-year survival than those in the lowest decile. Whites were 20% more likely to undergo surgery than Blacks and 31% more likely to survive 5 years. Multivariate procedures controlling for age and sex confirmed these observations.


CONCLUSIONS
Socioeconomic status and race appear to independently influence likelihood of survival. Failure to receive surgery explains much excess mortality.
Greenwald
H P
HP
School of Public Administration, University of Southern California, Sacramento 95814-2919, USA. greenwa@usc.edu
Polissar
N L
NL
Borgatta
E F
EF
McCorkle
R
R
Goodman
G
G
D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008175:Lung Neoplasms / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008824:Michigan; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D018426:SEER Program; D012495:San Francisco; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014861:Washington; D044465:White People / Q000706:statistics & numerical data*