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接受放射治疗作为初始治疗的非小细胞肺癌患者在治疗开始时间上的种族差异及治疗中心差异。

Racial and Treatment Center Differences on Time to Treatment Initiation for Nonsmall Cell Lung Cancer Patients Receiving Radiation Therapy As an Initial Treatment.

作者信息

Rekulapelli Akhil, Desai Raj P, Narayan Aditya, Martin Linda W, Hall Richard, Larner James M, Balkrishnan Rajesh

机构信息

University of Virginia School of Medicine, Charlottesville, Virginia, USA.

出版信息

Health Equity. 2022 Aug 18;6(1):603-609. doi: 10.1089/heq.2022.0104. eCollection 2022.

Abstract

OBJECTIVE

Because time to treatment has been shown to be associated with increase in the risk of death for Non Small Cell Lung Cancer (NSCLC) patients, we examined the prevalence and magnitude of racial disparities in mean time to radiation therapy (TTRT) for Stage I-III non-small cell lung cancer patients across a variety of treatment facilities.

METHODS

Utilizing the United States National Cancer Database (NCDB), we determined differences in TTRT between different races and different treatment facilities.

RESULTS

Concordant with past research, we found that non-White patients and patients treated at academic facilities, regardless of race, have longer mean TTRT, and that racial disparities in TTRT extend across all treatment facilities (all <0.05).

CONCLUSIONS

These findings shed light on the potential presence of and impact of structural racism on patients seeking cancer treatment, and the need for further investigation behind the reasonings behind longer TTI for non-White patients. To elucidate the real-world applicability of these results, further investigation into the societal determinants that perpetuate disparity in time to radiation therapy, and potential interventions in the clinical setting to improve cultural and racial sensitivity among healthcare professionals is recommended.

摘要

目的

由于已表明治疗时间与非小细胞肺癌(NSCLC)患者的死亡风险增加相关,我们研究了在各种治疗机构中,I - III期非小细胞肺癌患者接受放射治疗的平均时间(TTRT)方面种族差异的患病率和程度。

方法

利用美国国家癌症数据库(NCDB),我们确定了不同种族和不同治疗机构之间TTRT的差异。

结果

与过去的研究一致,我们发现非白人患者以及在学术机构接受治疗的患者(无论种族)平均TTRT更长,并且TTRT的种族差异在所有治疗机构中都存在(所有P<0.05)。

结论

这些发现揭示了结构性种族主义对寻求癌症治疗的患者可能存在的影响,以及对非白人患者TTRT较长背后原因进行进一步调查的必要性。为了阐明这些结果在现实世界中的适用性,建议进一步调查导致放射治疗时间差异持续存在的社会决定因素,以及在临床环境中进行潜在干预以提高医疗保健专业人员的文化和种族敏感性。

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