publication date: Dec. 6, 2019

Clinical Roundup

Study finds wide county-level variation in rates of surgery for early-stage lung cancer

A study finds more than two-fold differences between counties with the lowest and highest rates of surgery for patients with early stage lung cancer, with socioeconomic and healthcare delivery factors contributing to the gap. The study appears in Chest.

The authors of the current study recently reported substantial state-level variations in receipt of curative-intent surgery for NSCLC in the United States. For the current study, investigators at the American Cancer Society and Baptist Cancer Center, Memphis, led by Helmneh Sineshaw, looked at county-level variations within states to gain a sharper picture of the extent of care delivery problems.

A total of 179,189 patients 35 and older diagnosed with stage I/II NSCLC between 2007–2014 in 2,263 counties were identified from 39 states, the District of Columbia, and Detroit population-based cancer registries compiled by the North American Association of Central Cancer Registries. The percentage of patients who underwent surgery was calculated for each county with 20 or more cases of NSCLC.

The authors found surgery rates ranged from 12.8% to 48.6% in the 10% of counties with the lowest surgery rates to 74.3% to 91.7% in the 10% of counties with the highest rates of surgery. Pockets of low surgery rate-counties within each state were also identified. For example, there was a 25% absolute difference between the lowest and highest surgery receipt rate-counties in Massachusetts. Overall, counties in the lowest quartile for receipt of surgery were those with high proportion of non-Hispanic blacks, high poverty and uninsured rate, low surgeon-to-population ratio, and nonmetropolitan status.

“Receipt of curative-intent surgery for early-stage NSCLC varied substantially across counties in … Continue reading Study finds wide county-level variation in rates of surgery for early-stage lung cancer

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