Evidence map›Paper›PMID 40052387›Full record

ArticleCancer medicine2025

Mediators of Racial Inequities in Non-Small Cell Lung Cancer Care.

Safraz A Hamid, Do H Lee, Jeph Herrin, James B Yu, Craig E Pollack, Lorraine T Dean, Jacquelyne J Gaddy, Carol R Oladele, Shelli L Feder, Maureen E Canavan and 3 more

Abstract read
In one paragraph

Article in Cancer medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Safraz A HamidDepartment of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.ORCID https://orcid.org/0000-0001-8342-7760
Do H LeeCancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale Cancer Center, New Haven, Connecticut, USA.
Jeph HerrinCancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale Cancer Center, New Haven, Connecticut, USA.
James B YuCancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale Cancer Center, New Haven, Connecticut, USA.
Craig E PollackDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0003-2464-6415
Lorraine T DeanDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0002-2272-2755
Jacquelyne J GaddyCancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale Cancer Center, New Haven, Connecticut, USA.
Carol R OladeleEquity Research and Innovation Center (ERIC), Yale School of Medicine, Yale University, New Haven, Connecticut, USA.
Shelli L FederYale School of Nursing, Orange, Connecticut, USA.
Maureen E CanavanCancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale Cancer Center, New Haven, Connecticut, USA.ORCID https://orcid.org/0000-0001-9410-3542
Marcella Nunez-SmithDepartment of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
Pamela R SoulosCancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale Cancer Center, New Haven, Connecticut, USA.
Cary P GrossYale National Clinician Scholars Program, New Haven, Connecticut, USA.ORCID https://orcid.org/0000-0002-4974-935X

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Health System and Contextual Factors Associated with Racial Equity in Lung Cancer CareR01MD017569 · NIMHD · YALE UNIVERSITY · PI Cary P. Gross · 2022 to 2026
$3.2M
NCATS NIH HHS UL1 TR001863NCI NIH HHS R01MD017569NIMHD NIH HHS R01 MD017569
6 · The paper itself

Abstract

backgroundBlack patients with non-small cell lung cancer (NSCLC) are more often diagnosed at a later stage and receive inadequate evaluation and treatment compared to White patients. We aimed to identify factors representing exposure to structural racism that mediate the association between race and NSCLC care.

methodsWe queried Surveillance, Epidemiology, and End Results-Medicare for non-Hispanic Black and White patients ≥ 67 years diagnosed with NSCLC from 2013 to 2019. Our outcomes were localized diagnosis stage, receipt of stage-appropriate evaluation, receipt of stage-appropriate treatment, two-year survival, and receipt of "optimal" care, an aggregate metric comprising the first three listed outcomes. We estimated indirect effects of mediators on the association between race and outcomes.

resultsOf 69,130 patients, 8.2% were Black. Medicare-Medicaid dual eligibility, a marker of individual-level socioeconomic status (SES), accounted for the largest proportion of mediating effects for most outcomes, ranging from 13.6% (p < 0.001) for localized diagnosis stage to 25.0% (p < 0.001) for two-year survival. Receipt of an influenza vaccine, a marker of health care access, had the second largest mediating effects on the associations between race and diagnosis stage (9.5%, p < 0.001), treatment (15.3%, p < 0.001), and optimal care (11.4%, p < 0.001). Neighborhood-level SES accounted for the third largest proportion of the effects of race on each outcome, explaining between 9% and 16% of the racial inequities at each phase (all p < 0.001).

conclusionsIndividual- and neighborhood-level structural factors partly explain inequities in NSCLC care, and their effects vary based on the phase of care. Interventions should be adapted to the phase of care.

Indexed as

Black or African AmericanCarcinoma, Non-Small-Cell LungHealthcare DisparitiesLung NeoplasmsAgedAged, 80 and overFemaleHumansMaleMedicareRacismSEER ProgramUnited StatesWhitemediation analysisnon‐small cell lung cancerquality of careracial inequitiesstructural racism

Identifiers

PMID40052387
PMCPMC11886416

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.