Evidence That Established Lung Cancer Mortality Disparities in American Indians Are Not Due to Lung Cancer Genetic Testing and Targeted Therapy Disparities

Begnaud, Abbie; Yang, Ping; Robichaux, C.; Rubin, Nathan; Kratzke, Robert A.; Melzer, Anne C.; Aliferis, Constantin F.; Jacobson, Pamala A.

doi:10.1016/j.cllc.2019.10.012

Cited by 5 publications

(2 citation statements)

References 20 publications

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“…Disparities in genetic testing and mutational rates served as the primary focal point of five articles [ 47 – 51 ]. Genetic testing is the cornerstone of precision medicine.…”

Section: Resultsmentioning

confidence: 99%

“…Begnaud [ 47 ] examined genetic testing rates among American Indians and Alaska Natives residing in Minnesota, as these groups have been shown to experience higher lung cancer mortality rates than other races. Compared to matched controls, there was no significant difference in mutation testing in American Indians compared to Non-American Indian controls from five tertiary health systems in Minnesota covering a diverse demographic population and geographic area; suggesting that other factors are likely contributing to the higher mortality in this group.…”

Section: Resultsmentioning

confidence: 99%

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Disparities in Lung Cancer: A Targeted Literature Review Examining Lung Cancer Screening, Diagnosis, Treatment, and Survival Outcomes in the United States

Dwyer

Vadagam

Vanderpoel

et al. 2023

J. Racial and Ethnic Health Disparities

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Background Although incidence and mortality of lung cancer have been decreasing, health disparities persist among historically marginalized Black, Hispanic, and Asian populations. A targeted literature review was performed to collate the evidence of health disparities among these historically marginalized patients with lung cancer in the U.S. Methods Articles eligible for review included 1) indexed in PubMed®, 2) English language, 3) U.S. patients only, 4) real-world evidence studies, and 5) publications between January 1, 2018, and November 8, 2021. Results Of 94 articles meeting selection criteria, 49 publications were selected, encompassing patient data predominantly between 2004 and 2016. Black patients were shown to develop lung cancer at an earlier age and were more likely to present with advanced-stage disease compared to White patients. Black patients were less likely to be eligible for/receive lung cancer screening, genetic testing for mutations, high-cost and systemic treatments, and surgical intervention compared to White patients. Disparities were also detected in survival, where Hispanic and Asian patients had lower mortality risks compared to White patients. Literature on survival outcomes between Black and White patients was inconclusive. Disparities related to sex, rurality, social support, socioeconomic status, education level, and insurance type were observed. Conclusions Health disparities within the lung cancer population begin with initial screening and continue through survival outcomes, with reports persisting well into the latter portion of the past decade. These findings should serve as a call to action, raising awareness of persistent and ongoing inequities, particularly for marginalized populations.

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“…Disparities in genetic testing and mutational rates served as the primary focal point of five articles [ 47 – 51 ]. Genetic testing is the cornerstone of precision medicine.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Disparities in Lung Cancer: A Targeted Literature Review Examining Lung Cancer Screening, Diagnosis, Treatment, and Survival Outcomes in the United States

Dwyer

Vadagam

Vanderpoel

et al. 2023

J. Racial and Ethnic Health Disparities

View full text Add to dashboard Cite

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Indigenous access to clinical services along the lung cancer treatment pathway: a review of current evidence

Signal,

Smith,

Costello

et al. 2024

Cancer Causes Control

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Background Lung cancer is a deadly cancer. Early diagnosis and access to timely treatment are essential to maximizing the likelihood of survival. Indigenous peoples experience enduring disparities in lung cancer survival, and disparities in access to and through lung cancer services is one of the important drivers of these disparities. In this manuscript, we aimed to examine the current evidence on disparities in Indigenous access to services along the lung cancer treatment pathway. Methods A narrative literature review was conducted for all manuscripts and reports published up until July 20, 2022, using Medline, Scopus, Embase, and Web of Science. Following the identification of eligible literature, full-text versions were scanned for relevance for inclusion in this review, and relevant information was extracted. After scanning 1,459 documents for inclusion, our final review included 36 manuscripts and reports that included information on lung cancer service access for Indigenous peoples relative to non-Indigenous peoples. These documents included data from Aotearoa New Zealand, Australia, Canada, and the USA (including Hawai’i). Results Our review found evidence of disparities in access to, and the journey through, lung cancer care for Indigenous peoples. Disparities were most obvious in access to early detection and surgery, with inconsistent evidence regarding other components of the pathway. Conclusion These observations are made amid relatively scant data in a global sense, highlighting the need for improved data collection and monitoring of cancer care and outcomes for Indigenous peoples worldwide. Access to early detection and guideline-concordant treatment are essential to addressing enduring disparities in cancer survival experienced by Indigenous peoples globally.

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Racial and ethnic disparities in genomic testing among lung cancer patients: a systematic review

Meernik,

Raveendran,

Kolarova

et al. 2024

JNCI: Journal of the National Cancer Institute

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Introduction Racial and ethnic disparities in genomic testing could exacerbate disparities in access to precision cancer therapies and survival—particularly in the context of lung cancer, where genomic testing has been recommended for the past decade. However, prior studies assessing disparities in genomic testing have yielded mixed results. Methods We conducted a systemic review to examine racial and ethnic disparities in the use of genomic testing among lung cancer patients in the U.S. Two comprehensive searches in PubMed, Embase, and Scopus were conducted (September 2022, May 2023). Original studies that assessed rates of genomic testing by race or ethnicity were included. Findings were narratively synthesized by outcome. Results The search yielded 2,739 unique records, resulting in 18 included studies. All but one study was limited to patients diagnosed with non-small cell lung cancer. Diagnosis years ranged from 2007-2022. Eleven of 18 studies found statistically significant differences in the likelihood of genomic testing by race or ethnicity; in seven of these studies, testing was lower among Black patients compared to White or Asian patients. However, many studies lacked adjustment for key covariates and included patients with unclear eligibility for testing. Conclusions A majority of studies, though not all, observed racial and ethnic disparities in the use of genomic testing among patients with lung cancer. Heterogeneity of study results throughout a period of changing clinical guidelines suggests that minoritized populations—Black patients in particular—have faced additional barriers to genomic testing, even if not universally observed at all institutions.

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Evidence That Established Lung Cancer Mortality Disparities in American Indians Are Not Due to Lung Cancer Genetic Testing and Targeted Therapy Disparities

Cited by 5 publications

References 20 publications

Disparities in Lung Cancer: A Targeted Literature Review Examining Lung Cancer Screening, Diagnosis, Treatment, and Survival Outcomes in the United States

Disparities in Lung Cancer: A Targeted Literature Review Examining Lung Cancer Screening, Diagnosis, Treatment, and Survival Outcomes in the United States

Indigenous access to clinical services along the lung cancer treatment pathway: a review of current evidence

Racial and ethnic disparities in genomic testing among lung cancer patients: a systematic review

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