ArticleChest2020
County-Level Variations in Receipt of Surgery for Early-Stage Non-small Cell Lung Cancer in the United States.
Article in Chest, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Rural-Urban Disparities in Colorectal Cancer Screening, Diagnosis, Treatment, and Survivorship Care: A Systematic Review and Meta-Analysis.The oncologist · 2024Pooled it
- Trends in Radiation Use from 2004 to 2020 among Adolescents and Young Adults with Hodgkin Lymphoma.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Article
- Medicaid Expansion and County-Level Suicide: Disparities Based on Rurality and Mental Health Provider Shortages.Psychiatric services (Washington, D.C.) · 2025Article
- County socioeconomic status and premature mortality from cancer in the United States.Cancer epidemiology · 2025Article
- Assessing populations with access to National Cancer Institute-funded sites using local distance-based service areas.Journal of clinical and translational science · 2025Article
- Impact of Medicaid expansion under the Patient Protection and Affordable Care Act on lung cancer care in the US.Journal of thoracic disease · 2024Article
- The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use - results of a scoping review.International journal for equity in health · 2024Article
- The global burden of lung cancer: current status and future trends.Nature reviews. Clinical oncology · 2023Review
- Novel Image-Guided Flexible-Probe Transbronchial Microwave Ablation for Stage 1 Lung Cancer.Respiration; international review of thoracic diseases · 2023Article
- Rural-urban survival disparities for patients with surgically treated lung cancer.Journal of surgical oncology · 2022Article
- Rural-Urban Disparities in Cancer Outcomes: Opportunities for Future Research.Journal of the National Cancer Institute · 2022Review
- Surgery without preoperative histological confirmation of lung cancer: what is the current clinical practice?Journal of thoracic disease · 2021Article
- County-Level Variation in Utilization of Surgical Resection for Early-Stage Hepatopancreatic Cancer Among Medicare Beneficiaries in the USA.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Narrative review of socioeconomic and racial disparities in the treatment of early stage lung cancer.Journal of thoracic disease · 2021Review
- Institutional-Level Differences in Quality and Outcomes of Lung Cancer Resections in the United States.Chest · 2021Article
- Volume-Based Care Regionalization: Pitfalls and Challenges.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020Article
- Rurality, Stage-Stratified Use of Treatment Modalities, and Survival of Non-small Cell Lung Cancer.Chest · 2020Article
- American Cancer Society's Report on the Status of Cancer Disparities in the United States, 2025.CA: a cancer journal for cliniciansArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundAlthough counties are the smallest geographic level for comprehensive health-care delivery analysis, little is known about county-level variations in receipt of curative-intent surgery for early-stage non-small cell lung cancer (NSCLC) and factors contributing to such variations in the United States.
methodsA total of 179,189 patients aged ≥ 35 years who were diagnosed with stage I to II NSCLC between 2007 and 2014 in 2,263 counties were identified from 39 states, the District of Columbia, and Detroit population-based cancer registries; the data were compiled by the North American Association of Central Cancer Registries. The percentage of patients who underwent surgery was calculated for each county with ≥ 20 cases. Adjusted risk ratios were generated by using generalized estimating equation models with modified Poisson regression.
resultsReceipt of surgery for early-stage NSCLC during 2007 to 2014 according to county ranged from 12.8% to 48.6% in the lowest decile of counties, to 74.3% to 91.7% in the highest decile of counties. There were pockets of low surgery receipt rate counties within each state. For example, there was a 25% absolute difference between the lowest and highest surgery receipt rate counties in Massachusetts. Counties in the lowest quartile for receipt of surgery were those with a high proportion of non-Hispanic black subjects, high poverty and uninsured rates, low surgeon-to-population ratio, and nonmetropolitan status.
conclusionsReceipt of curative-intent surgery for early-stage NSCLC varied substantially across counties in the United States, with pockets of low receipt counties in each state. Low surgery receipt counties were characterized by unfavorable area-level socioeconomic and health-care delivery factors.
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