ArticleFuture oncology (London, England)2025
Trends in initial primary treatment approach and biomarker testing across social determinants of health in early-stage non-small cell lung cancer.
Article in Future oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
aimTo evaluate the impact of a comprehensive set of social determinants of health (SDOH) on treatments, timing, and key biomarker testing for early-stage non-small cell lung cancer (NSCLC).
methodsPatients with the first diagnosis of stage I-III NSCLC from 1 January 2015 to 15 October 2023 and treated at community health systems in the United States were eligible for this retrospective database study. We summarized initial primary treatment and time-to-treatment initiation (TTI) by Social Vulnerability Index (SVI), primary care provider (PCP) shortage areas, household income, and insurance type. Data cutoff was 15 October 2024.
resultsOf 8501 patients with stage I-III NSCLC, 32% underwent surgery-only and 14% also received neoadjuvant and/or adjuvant therapy. Greater percentages underwent surgery (with/without neoadjuvant/adjuvant therapy) in counties with lowest SVI/vulnerability, highest median income, and no PCP shortage, and among those with private healthcare insurance (vs. Medicare/Medicaid). Median (range) TTI for any NSCLC-related treatment after diagnosis was 41 days (0-1846); TTI increased across treatment strategies by increasing SVI/vulnerability and decreasing household income. Annual rates of programmed death-ligand 1/
conclusionsDisparities in early-stage NSCLC treatment by SDOH factors call for efforts to improve access to timely care for NSCLC.
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