Department of Public Health, California State University, Fullerton, Fullerton, California, USA.
Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, Maryland, USA.
Cancer Med. 2023 Mar;12(6):7427-7437. doi: 10.1002/cam4.5450. Epub 2022 Nov 17.
Lung cancer (LC) continues to be the leading cause of cancer deaths in the United States. Surgical treatment has proven to offer a favorable prognosis and a better 5-year relative survival for patients with early or localized tumors. This novel study investigates the factors associated with the odds of receiving surgical treatment for localized malignant LC in Tennessee.
Population-based data of 9679 localized malignant LC patients from the Tennessee Cancer Registry (2005-2015) were utilized to examine the factors associated with receiving surgical treatment for localized malignant LC. Bivariate and multivariate logistic regression analyses, cross-tabulation, and Chi-Square ( ) tests were conducted to assess these factors.
Patients with localized malignant LC who initiated treatment after 2.7 weeks were 46% less likely to receive surgery (adjusted odds ratio [AOR] = 0.54; 95% confidence interval [CI] = 0.50-0.59; p < 0.0001). Females had a greater likelihood (AOR = 1.14; CI = 1.03-1.24) of receiving surgical treatment compared to men. Blacks had lower odds (AOR = 0.76; CI = 0.65-0.98) of receiving surgical treatment compared to Whites. All marital groups had higher odds of receiving surgical treatment compared to those who were single/never married. Patients living in Appalachian county had lower odds of receiving surgical treatment (AOR = 0.65; CI = 0.59-0.71) compared with those in the non-Appalachian county. Patients with private (AOR = 2.09; CI = 1.55-2.820) or public (AOR = 1.42; CI = 1.06-1.91) insurance coverage were more likely to receive surgical treatment compared to self-pay/uninsured patients. Overall, the likelihood of patients receiving surgical treatment for localized malignant LC decreases with age.
Disparities exist in the receipt of surgical treatment among patients with localized malignant LC in Tennessee. Health policies should target reducing these disparities to improve the survival of these patients.
肺癌（LC）仍然是美国癌症死亡的主要原因。手术治疗已被证明为早期或局部肿瘤患者提供了有利的预后和更好的 5 年相对生存率。这项新的研究调查了与田纳西州局部恶性 LC 患者接受手术治疗的几率相关的因素。
利用田纳西州癌症登记处（2005-2015 年）的 9679 名局部恶性 LC 患者的基于人群的数据，研究与接受局部恶性 LC 手术治疗相关的因素。进行了双变量和多变量逻辑回归分析、交叉表和卡方（ ）检验，以评估这些因素。
在 2.7 周后开始治疗的局部恶性 LC 患者接受手术的可能性降低了 46%（调整后的优势比 [AOR] = 0.54；95%置信区间 [CI] = 0.50-0.59；p < 0.0001）。与男性相比，女性接受手术治疗的可能性更大（AOR = 1.14；CI = 1.03-1.24）。与白人相比，黑人接受手术治疗的可能性较低（AOR = 0.76；CI = 0.65-0.98）。与单身/未婚者相比，所有婚姻群体接受手术治疗的可能性更高。与非阿巴拉契亚县相比，居住在阿巴拉契亚县的患者接受手术治疗的可能性较低（AOR = 0.65；CI = 0.59-0.71）。与自付/无保险的患者相比，有私人（AOR = 2.09；CI = 1.55-2.82）或公共（AOR = 1.42；CI = 1.06-1.91）保险的患者更有可能接受手术治疗。总体而言，随着年龄的增长，患者接受局部恶性 LC 手术治疗的可能性降低。
田纳西州局部恶性 LC 患者在接受手术治疗方面存在差异。卫生政策应针对减少这些差异，以提高这些患者的生存率。
