Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY.
Department of Radiation Oncology, Duke University, Durham, NC.
Am J Clin Oncol. 2024 Jan 1;47(1):40-47. doi: 10.1097/COC.0000000000001063. Epub 2023 Oct 26.
The Hispanic/Latinx population has consistently faced disparities in oncology access and outcomes with cancer being the leading cause of death in this population. We evaluate recent research in radiation therapy disparities among the Hispanic/Latinx population in the United States since our seminal analysis from 2017.
A PubMed literature search was conducted for articles published from January 2017 through March 2023. Four term combinations were utilized, including: (1) "Hispanic" and "Radiotherapy" and "Disparities", (2) "Latino" and "Radiotherapy" and "Hispanic", (3) "Hispanic" and "Radiation" and "Disparities", and (4) "Latino" and "Radiation" and "Disparities." Included studies were those taking place in the United States, examined radiation oncology care, and examined health disparities.
Fifty-eight of 245 articles returned met inclusion criteria and spanned 6 disparity-types: (1) Stage at Presentation, (2) Time to Treatment Initiation & Completion, (3) Receipt of Treatment and Guideline-Concordant Care, (4) Geography, (5) Clinical Trial Access and (6) Insurance Barriers and Treatment Center Type. The most common disparity was receipt of treatment and guideline-concordant care (n=39 studies), demonstrating that the Hispanic/Latinx population was less likely to receive guideline-concordant treatment or treatment at all. In additon, studies identified disparities in time to treatment and completion (n=12), geography (n=5), clinical trial access (n=3), and insurance and treatment center access (n=5).
Disparities in radiotherapy access remain prominent for the Hispanic/Latinx population through a multitude of barriers, despite increasing interest in disparities research. Continued health care disparities research with tangible interventions are needed in radiation oncology to properly understand and address this problem.
西班牙裔/拉丁裔人群在肿瘤学治疗方面一直存在差异,癌症是该人群的主要死亡原因。自 2017 年我们的开创性分析以来,我们评估了美国西班牙裔/拉丁裔人群在放射治疗方面的最新研究。
对 2017 年 1 月至 2023 年 3 月期间发表的文章进行了 PubMed 文献检索。使用了四个术语组合,包括:(1)“西班牙裔”和“放射治疗”和“差异”,(2)“拉丁裔”和“放射治疗”和“西班牙裔”,(3)“西班牙裔”和“放射”和“差异”,以及(4)“拉丁裔”和“放射”和“差异”。纳入的研究是在美国进行的,检查了放射肿瘤学治疗,并检查了健康差异。
245 篇文章中有 58 篇符合纳入标准,涵盖了 6 种差异类型:(1) 就诊时的分期,(2) 治疗开始和完成的时间,(3) 接受治疗和符合指南的护理,(4) 地理,(5) 临床试验的机会和(6) 保险障碍和治疗中心类型。最常见的差异是接受治疗和符合指南的护理(n=39 项研究),这表明西班牙裔/拉丁裔人群接受符合指南的治疗或治疗的可能性较小。此外,研究还确定了治疗和完成时间(n=12)、地理(n=5)、临床试验机会(n=3)以及保险和治疗中心机会(n=5)的差异。
尽管对差异研究的兴趣日益浓厚,但西班牙裔/拉丁裔人群在放射治疗方面仍然存在多种障碍,导致获得放射治疗的机会不平等。在放射肿瘤学中需要进行更多的医疗保健差异研究,并采取切实可行的干预措施,以正确理解和解决这一问题。