Coughlin Steven S, Matthews-Juarez Patricia, Juarez Paul D, Melton Courtnee E, King Mario
Research Center on Health Disparities, Equity, and the Exposome, University of Tennessee College of Medicine, Memphis, Tennessee; Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
Cancer Med. 2014 Dec;3(6):1467-76. doi: 10.1002/cam4.348. Epub 2014 Sep 14.
Race and socioeconomic status are well known to influence lung cancer incidence and mortality patterns in the U.S. Lung cancer incidence and mortality rates are higher among blacks than whites. In this article we review opportunities to address disparities in lung cancer incidence, mortality, and survivorship among African Americans. First, we summarize recent advances in the early detection and treatment of lung cancer. Then we consider black-white disparities in lung cancer treatment including factors that may contribute to such disparities; the literature on smoking cessation interventions for patients with or without a lung cancer diagnosis; and the important roles played by cultural competency, patient trust in their physician, and health literacy in addressing lung cancer disparities, including the need for culturally competent lung cancer patient navigators. Intervention efforts should focus on providing appropriate quality treatment for lung cancer and educating African Americans about the value of having these treatments in order to reduce these disparities. Culturally competent, patient navigation programs are needed that support lung cancer patients, especially socioeconomically disadvantaged patients, from the point of diagnosis to the initiation and completion of treatment, including cancer staging.
众所周知，种族和社会经济地位会影响美国肺癌的发病率和死亡率模式。黑人的肺癌发病率和死亡率高于白人。在本文中，我们回顾了消除非裔美国人在肺癌发病率、死亡率和生存率方面差异的机会。首先，我们总结肺癌早期检测和治疗的最新进展。然后，我们考虑肺癌治疗方面的黑白差异，包括可能导致这种差异的因素；针对有或没有肺癌诊断的患者的戒烟干预措施的文献；以及文化能力、患者对医生的信任和健康素养在解决肺癌差异方面所起的重要作用，包括对具备文化能力的肺癌患者导航员的需求。干预措施应侧重于为肺癌提供适当的高质量治疗，并向非裔美国人宣传接受这些治疗的价值，以减少这些差异。需要有具备文化能力的患者导航项目，从诊断到治疗的开始和完成，包括癌症分期，为肺癌患者，尤其是社会经济地位不利的患者提供支持。
