Dana-Farber Cancer Institute, Boston, MA, USA.
Jefferson University Hospitals, Philadelphia, PA, USA.
J Natl Med Assoc. 2023 May;115(2S):S46-S53. doi: 10.1016/j.jnma.2023.02.004.
Lung cancer is the second most common cancer and the leading cause of cancer death among men and women in the United States. Despite a substantial decline in lung cancer incidence and mortality across all races in the last few decades, medically underserved racial and ethnic minority populations continue to carry the greatest burden of disease throughout the lung cancer continuum. Black individuals experience a higher incidence of lung cancer due to lower rates of low-dose computed tomography screening, which translate into advanced disease stage at diagnosis and poorer survival outcomes compared with White individuals. With respect to treatment, Black patients are less likely to receive gold standard surgery, have access to biomarker testing or high-quality treatment compared with White patients. The reasons for those disparities are multifactorial and include socioeconomic (eg, poverty, lack of health insurance, and inadequate education), and geographic inequalities. The objective of this article is to review the sources of racial and ethnic disparities in lung cancer, and to propose recommendations to help address them.
肺癌是美国男性和女性中第二常见的癌症,也是癌症死亡的主要原因。尽管在过去几十年中,所有种族的肺癌发病率和死亡率都有了大幅下降,但在医疗服务不足的种族和少数民族群体中,疾病负担仍然最大。由于低剂量计算机断层扫描筛查率较低,黑人患肺癌的发病率较高,这导致诊断时疾病分期较晚,与白人相比生存结果较差。在治疗方面,与白人患者相比,黑人患者接受黄金标准手术、进行生物标志物检测或高质量治疗的可能性较小。造成这些差异的原因是多方面的,包括社会经济因素(如贫困、缺乏医疗保险和教育程度低)和地理不平等。本文的目的是回顾肺癌中存在的种族和民族差异的根源,并提出建议以帮助解决这些差异。