Section of Pulmonary, Allergy, and Critical Care Medicine. Boston University Chobanian and Avedisian School of Medicine.
Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System.
Curr Opin Pulm Med. 2024 Jul 1;30(4):359-367. doi: 10.1097/MCP.0000000000001064. Epub 2024 Feb 23.
Lung cancer remains the leading cause of cancer mortality worldwide. Health disparities have long been noted in lung cancer incidence and survival and persist across the continuum of care. Understanding the gaps in care that arise from disparities in lung cancer risk, screening, treatment, and survivorship are essential to guiding efforts to achieve equitable care.
Recent literature continues to show that Black people, women, and people who experience socioeconomic disadvantage or live in rural areas experience disparities throughout the spectrum of lung cancer care. Contributing factors include structural racism, lower education level and health literacy, insurance type, healthcare facility accessibility, inhaled carcinogen exposure, and unmet social needs. Promising strategies to improve lung cancer care equity include policy to reduce exposure to tobacco smoke and harmful pollutants, more inclusive lung cancer screening eligibility criteria, improved access and patient navigation in lung cancer screening, diagnosis and treatment, more deliberate offering of appropriate surgical and medical treatments, and improved availability of survivorship and palliative care.
Given ongoing disparities in lung cancer care, research to determine best practices for narrowing these gaps and to guide policy change are an essential focus of future lung cancer research.
肺癌仍然是全球癌症死亡的主要原因。肺癌的发病率和存活率一直存在着健康差异,并且在整个治疗过程中都存在着这种差异。了解由于肺癌风险、筛查、治疗和生存方面的差异而导致的护理差距,对于指导实现公平护理的努力至关重要。
最近的文献继续表明,黑人、女性以及经历社会经济劣势或居住在农村地区的人在肺癌治疗的各个方面都存在差异。造成这些差异的因素包括结构性种族主义、较低的教育水平和健康素养、保险类型、医疗机构的可及性、吸入性致癌物质暴露以及未满足的社会需求。改善肺癌护理公平性的有前景的策略包括减少吸烟和有害污染物暴露的政策、更具包容性的肺癌筛查资格标准、改善肺癌筛查、诊断和治疗中的获得途径和患者导航、更慎重地提供适当的手术和医疗治疗、以及提高生存和姑息治疗的可及性。
鉴于肺癌护理方面持续存在的差异,研究确定缩小这些差距的最佳实践并指导政策变化是未来肺癌研究的一个重要重点。