Kava Christine M, Siegel David A, Qin Jin, Sabatino Susan A, Wilson Reda, Wu Manxia
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA.
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
Chest. 2025 Apr;167(4):1218-1231. doi: 10.1016/j.chest.2024.10.033. Epub 2024 Oct 26.
Treatment for lung cancer can improve prognosis, but 5-year survival remains low at 26%. An examination of treatment using data with higher population coverage, and among a broader number of treatment modalities and individual characteristics, would provide greater insight into differences in lung cancer treatment.
Among adults diagnosed with lung cancer, how does reported receipt of lung cancer treatment differ by sociodemographic characteristics?
We used 2015-2020 National Program of Cancer Registry data covering 89% of the US population to describe first-course treatment among people aged ≥ 20 years and diagnosed with lung and bronchus cancer. We performed multivariable logistic regression to examine associations between sociodemographic characteristics and treatment received.
Among 1,068,155 people diagnosed with lung cancer, 22% received surgery, 41% received chemotherapy, 40% received radiation, 13% received immunotherapy, and 75% received at least one of the four treatments. People who were aged ≥ 45 years (OR range, 0.08-0.67); were of American Indian or Alaska Native (OR, 0.82; 95% CI, 0.77-0.87), Black (OR, 0.82; 95% CI, 0.81-0.84), or Hispanic (OR, 0.80; 95% CI, 0.78-0.82) race/ethnicity; resided in a nonmetropolitan county (OR, 0.98; 0.96-0.99); resided in the bottom 25% (OR, 0.80; 95% CI, 0.78-0.81) and middle 50% (OR, 0.87; 95% CI, 0.86-0.88) of counties by economic status (considers unemployment rate, per capita market income, and poverty rate); and in the West US census region (OR, 0.95; 95% CI, 0.94-0.97) had significantly lower odds of receiving at least 1 of the 4 treatments.
Chemotherapy and radiation were the most common types of first-course treatment reported. Receipt of at least one of the four treatments examined was lower among several groups, including certain racial and ethnic groups and those residing in counties with lower economic status. Future studies might further identify and intervene on factors underlying differences.
肺癌治疗可改善预后，但5年生存率仍较低，仅为26%。利用覆盖范围更广的人群数据，以及更多的治疗方式和个体特征来研究肺癌治疗情况，将能更深入了解肺癌治疗的差异。
在被诊断为肺癌的成年人中，报告的肺癌治疗接受情况在社会人口学特征方面有何不同？
我们使用了2015 - 2020年国家癌症登记计划数据，该数据覆盖了89%的美国人口，以描述年龄≥20岁且被诊断为肺癌和支气管癌的人群的首次治疗情况。我们进行了多变量逻辑回归分析，以研究社会人口学特征与接受治疗之间的关联。
在1,068,155名被诊断为肺癌的患者中，22%接受了手术，41%接受了化疗，40%接受了放疗，13%接受了免疫治疗，75%接受了这四种治疗中的至少一种。年龄≥45岁的人群（比值比范围为0.08 - 0.67）；美洲印第安人或阿拉斯加原住民（比值比为0.82；95%置信区间为0.77 - 0.87）、黑人（比值比为0.82；95%置信区间为0.81 - 0.84）或西班牙裔（比值比为0.80；95%置信区间为0.78 - 0.82）种族/族裔的人群；居住在非都市县的人群（比值比为0.98；0.96 - 0.99）；居住在经济状况（考虑失业率、人均市场收入和贫困率）处于底部25%（比值比为0.80；95%置信区间为0.78 - 0.81）和中间50%（比值比为0.87；95%置信区间为0.86 - 0.88）县的人群；以及居住在美国西部人口普查区的人群（比值比为0.95；95%置信区间为0.94 - 0.97）接受这四种治疗中至少一种的几率显著较低。
化疗和放疗是报告中最常见的首次治疗类型。在包括某些种族和族裔群体以及居住在经济状况较低县的人群在内的几个群体中，接受所研究的四种治疗中至少一种的比例较低。未来的研究可能会进一步确定并干预造成差异的潜在因素。
