ArticlePloS one2025
Disparities in time to treatment initiation of invasive lung cancer among Black and White patients in Tennessee.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Geographic Access to Low-Dose CT Lung Cancer Screening in Tennessee: Disparities by Socioeconomic Variables, Rurality, and Appalachian Status.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Sex-Based Disparities in Interval Time to Receipt of Surgical Treatment of Invasive Lung Cancer in Tennessee.Research square · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
backgroundEarly initiation of treatment for lung cancer has been shown to improve patient survival. The present study investigates disparities in time to treatment initiation of invasive lung cancer within and between Black and White patients in Tennessee.
methodsA population-based registry data of 42,970 individuals (Black = 4,480 and White = 38,490) diagnosed with invasive lung cancer obtained from the Tennessee Cancer Registry, 2005-2015, was analyzed. We conducted bivariate ANOVA tests to examine the difference in time to treatment initiation among independent factors, and multivariable Cox proportional hazard models to identify independent factors that influence median time to treatment initiation after diagnosis.
resultsWhen considering the estimate of the proportion of time to treatment initiation based on the combined influence of all independent factors (sex, age, race, marital, county of residence, health insurance, cancer stage, and surgical treatment), Black patients were generally more at risk of delayed treatment compared to Whites. Black patients aged <45 years (adjusted hazard ratio [aHR] = 1.40; 95% confidence interval [CI] = 1.01-1.94) and married White patients (aHR = 1.13; 95% CI = 1.07-1.18) had the highest increased risk of late treatment among their respective racial subgroups. In the general sample, patients with private health insurance had (aHR = 1.08; 95% CI = 1.01-1.16) higher risk of late treatment beyond 2.7 weeks compared to self-pay/uninsured patients. This was consistent among both Black and White subsamples. Patients with localized and regional lung cancer stages had a decreased risk of delayed treatment compared to those diagnosed at the distant stage among both Black and White patients.
conclusionsBlack patients were often at greater risk of late initiation of treatment for invasive lung cancer in Tennessee. Additional research is needed to understand factors influencing time to treatment initiation for Black patients in Tennessee. Further, cancer care resources are needed in Black communities to ensure timely treatment of invasive lung cancer, reduce disparities, and promote equitable care for all cancer patients.
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