Cargando…

Racial and ethnic inequities of palliative care use among advanced Non‐Small cell lung cancer patients in the US

BACKGROUND: With early intervention, palliative care (PC) can improve quality of life and increase survival among advanced‐stage non‐small cell lung cancer (aNCSLC) patients. However, PC is often offered late in the cancer treatment course and is underused. We characterized racial/ethnic inequities...

Descripción completa

Detalles Bibliográficos
Autores principales: Islam, Jessica Y., Braithwaite, Dejana, Zhang, Dongyu, Guo, Yi, Tailor, Tina D., Akinyemiju, Tomi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134338/
https://www.ncbi.nlm.nih.gov/pubmed/36533434
http://dx.doi.org/10.1002/cam4.5538
_version_ 1785031741590732800
author Islam, Jessica Y.
Braithwaite, Dejana
Zhang, Dongyu
Guo, Yi
Tailor, Tina D.
Akinyemiju, Tomi
author_facet Islam, Jessica Y.
Braithwaite, Dejana
Zhang, Dongyu
Guo, Yi
Tailor, Tina D.
Akinyemiju, Tomi
author_sort Islam, Jessica Y.
collection PubMed
description BACKGROUND: With early intervention, palliative care (PC) can improve quality of life and increase survival among advanced‐stage non‐small cell lung cancer (aNCSLC) patients. However, PC is often offered late in the cancer treatment course and is underused. We characterized racial/ethnic inequities and the role of healthcare access in PC use among patients with aNSCLC. METHODS: We used data from the 2004–2016 National Cancer Database, including adults aged 18–90 years with aNSCLC (stage 3 or 4 at diagnosis; n = 803,618). Based on the NCCN guidelines, PC includes non‐curative surgery, radiation, chemotherapy, pain management, or any combination of non‐curative care. We examined PC use by sociodemographic and health care‐level characteristics. To evaluate the independent associations of race/ethnicity and health care access characteristics with PC, we estimated adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). Covariate adjustment sets varied by exposure determined using directed acyclic graphs. RESULTS: Our population was 55% male and 77% non‐Hispanic/Latinx (NH)‐White, with a mean age of 68 years. Overall, 19% of patients with aNSCLC used PC. Compared to NH‐White patients, NH‐Black (aOR:0.91,95% CI:0.89–0.93) and Hispanic/Latinx (aOR:0.80,95% CI:0.77–0.83) patients were less likely to use PC, whereas Indigenous (AI/AN) (aOR:1.18,95% CI:1.06–1.31) and Native Hawaiian/Pacific Islander (aOR:2.08,95% CI:1.83–2.36) patients were more likely. Overall, compared to the privately‐insured, uninsured (aOR:1.19,95% CI:1.11–1.28) and Medicaid‐insured patients (aOR:1.19,95% CI:1.14–1.25) were more likely to use PC. CONCLUSION: PC is underutilized among NH‐Black and Hispanic/Latinx patients with aNSCLC. Insurance type may play a role in PC use among patients with aNSCLC.
format Online
Article
Text
id pubmed-10134338
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-101343382023-04-28 Racial and ethnic inequities of palliative care use among advanced Non‐Small cell lung cancer patients in the US Islam, Jessica Y. Braithwaite, Dejana Zhang, Dongyu Guo, Yi Tailor, Tina D. Akinyemiju, Tomi Cancer Med RESEARCH ARTICLES BACKGROUND: With early intervention, palliative care (PC) can improve quality of life and increase survival among advanced‐stage non‐small cell lung cancer (aNCSLC) patients. However, PC is often offered late in the cancer treatment course and is underused. We characterized racial/ethnic inequities and the role of healthcare access in PC use among patients with aNSCLC. METHODS: We used data from the 2004–2016 National Cancer Database, including adults aged 18–90 years with aNSCLC (stage 3 or 4 at diagnosis; n = 803,618). Based on the NCCN guidelines, PC includes non‐curative surgery, radiation, chemotherapy, pain management, or any combination of non‐curative care. We examined PC use by sociodemographic and health care‐level characteristics. To evaluate the independent associations of race/ethnicity and health care access characteristics with PC, we estimated adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). Covariate adjustment sets varied by exposure determined using directed acyclic graphs. RESULTS: Our population was 55% male and 77% non‐Hispanic/Latinx (NH)‐White, with a mean age of 68 years. Overall, 19% of patients with aNSCLC used PC. Compared to NH‐White patients, NH‐Black (aOR:0.91,95% CI:0.89–0.93) and Hispanic/Latinx (aOR:0.80,95% CI:0.77–0.83) patients were less likely to use PC, whereas Indigenous (AI/AN) (aOR:1.18,95% CI:1.06–1.31) and Native Hawaiian/Pacific Islander (aOR:2.08,95% CI:1.83–2.36) patients were more likely. Overall, compared to the privately‐insured, uninsured (aOR:1.19,95% CI:1.11–1.28) and Medicaid‐insured patients (aOR:1.19,95% CI:1.14–1.25) were more likely to use PC. CONCLUSION: PC is underutilized among NH‐Black and Hispanic/Latinx patients with aNSCLC. Insurance type may play a role in PC use among patients with aNSCLC. John Wiley and Sons Inc. 2022-12-19 /pmc/articles/PMC10134338/ /pubmed/36533434 http://dx.doi.org/10.1002/cam4.5538 Text en © 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Islam, Jessica Y.
Braithwaite, Dejana
Zhang, Dongyu
Guo, Yi
Tailor, Tina D.
Akinyemiju, Tomi
Racial and ethnic inequities of palliative care use among advanced Non‐Small cell lung cancer patients in the US
title Racial and ethnic inequities of palliative care use among advanced Non‐Small cell lung cancer patients in the US
title_full Racial and ethnic inequities of palliative care use among advanced Non‐Small cell lung cancer patients in the US
title_fullStr Racial and ethnic inequities of palliative care use among advanced Non‐Small cell lung cancer patients in the US
title_full_unstemmed Racial and ethnic inequities of palliative care use among advanced Non‐Small cell lung cancer patients in the US
title_short Racial and ethnic inequities of palliative care use among advanced Non‐Small cell lung cancer patients in the US
title_sort racial and ethnic inequities of palliative care use among advanced non‐small cell lung cancer patients in the us
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134338/
https://www.ncbi.nlm.nih.gov/pubmed/36533434
http://dx.doi.org/10.1002/cam4.5538
work_keys_str_mv AT islamjessicay racialandethnicinequitiesofpalliativecareuseamongadvancednonsmallcelllungcancerpatientsintheus
AT braithwaitedejana racialandethnicinequitiesofpalliativecareuseamongadvancednonsmallcelllungcancerpatientsintheus
AT zhangdongyu racialandethnicinequitiesofpalliativecareuseamongadvancednonsmallcelllungcancerpatientsintheus
AT guoyi racialandethnicinequitiesofpalliativecareuseamongadvancednonsmallcelllungcancerpatientsintheus
AT tailortinad racialandethnicinequitiesofpalliativecareuseamongadvancednonsmallcelllungcancerpatientsintheus
AT akinyemijutomi racialandethnicinequitiesofpalliativecareuseamongadvancednonsmallcelllungcancerpatientsintheus