ArticleJTCVS open2023
Delays to surgery and worse outcomes: The compounding effects of social determinants of health in non-small cell lung cancer.
Article in JTCVS open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Social Determinants of Health Coding Among Hospital Visits Made by Adults With Cancer.JCO oncology practice · 2026Article
- Article
- Social Vulnerability is Associated with Significant Delays to Definitive Surgery for Stages IA to IIIA Non-small Cell Lung Cancer and Consequential Increased Rates of Pathologic Upstaging.Annals of surgical oncology · 2026Article
- Redefining treatment interval in lung cancer surgery in the era of prehabilitation: a systematic review.Translational lung cancer research · 2025Review
- Delay of Systemic Therapy Confers a Survival Benefit in Patients with Stage IV Non-Small-Cell Lung Cancer.Cancers · 2025Article
- Public Insurance and Language Preferences Are Associated With a Longer Time to Surgery for Distal Radius Fractures.The Journal of the American Academy of Orthopaedic Surgeons · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
Objective: To quantify the compounding effects of social determinants of health on time to surgery (T2S) and clinical outcomes. Methods: The National Cancer Database was queried for treatment-naïve patients with cT1-4N0-1M0 non-small cell lung cancer undergoing (bi)lobectomy or pneumonectomy between 2006 and 2016 with 1 to 180 days T2S, the number of days between diagnosis and surgery; surgical delays were defined as statistically significant increased T2S compared with a reference cohort. Social determinants of health factors prognostic for surgical delays were identified using multivariable regression. The 30-/90-day mortality and 5-year survival estimates were calculated using logistic and Cox regressions, respectively. Results: In total, 110,005 patients met inclusionary criteria. Multivariable analysis identified race, insurance, and facility type as factors with significant 3-way interaction: T2S of one depended on the others. Income and education also contributed to delays. Privately insured (private) non-Hispanic White patients at academic medical centers (AMCs) were the reference with T2S of 44.1 days. At AMCs, private Black patients had significant delays to surgery (54.7 days; Conclusions: In treatment-naïve patients with cT1-4N0-1M0 non-small cell lung cancer, Black race, Medicaid, uninsured status, and AMCs generate compounding surgical delays with increased 30-/90-day mortality and decreased 5-year survival. Thoracic surgeons can leverage these facility and demographic-specific insights to standardize time to surgery and begin mitigating underlying disparities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.