Racial disparities in lung cancer persist: Here’s how clinicians can help

By Jules Murtha | Fact-checked by Barbara Bekiesz
Published March 27, 2023

Key Takeaways

  • According to the American Lung Association, the national survival rate for patients with lung cancer has risen to 25%, while the survival rate for communities of color sits at 20%.

  • Experts say that Black patients often struggle to access timely appointments following abnormal results, as well as early diagnoses.

  • In order to better support patients of color with lung cancer, HCPs can provide timelier lung cancer surgery through the implementation of antiracism strategies.

Each day, 356 people across the US lose their battle with lung cancer. What’s more, another person is told they have lung cancer nearly every two and a half minutes, according to the American Lung Association.

Described as the “most lethal solid organ malignancy in the United States” by researchers writing in an article in the Journal of Thoracic Disease,[] lung cancer doesn’t necessarily discriminate based on race.

Physicians can help to mitigate racial disparities in lung cancer by implementing non-discriminatory systems and strategies in the exam room.

People of color have higher lung cancer mortality

When it comes to lung cancer, the data speaks loud and clear: People of color experience worse overall health outcomes when compared with their White counterparts with the same illness.

According to a 2022 report fromthe American Lung Association, the national survival rate for Americans with lung cancer rose from 21% to 25% in the last 5 years. For communities of color, however, that statistic remains at 20%.[]

This may be a result of the differences in care that communities of color tend to receive.

“Patients of color, particularly Black patients, tend to have less access to care, less timely follow-up when there’s an abnormal finding, and later stages of diagnosis,” epidemiologist Louise Henderson, PhD, told Kaiser Health News (KHN).[] 

The issue of later-stage diagnosis is particularly poignant, since early diagnosis is crucial to survival in many cases.

In discussing the racial disparities in lung cancer research, the KHN article pointed out that only 4.4% of participants in the National Lung Screening Trial were Black—despite the fact that Black people make up 13% of the US population.

This lack of representation of Blacks in clinical studies may very well be one reason why Black patients deal with delayed disease detection and higher mortality rates, experts say.

All in all, people of color—especially Black people—experience worse health outcomes related to lung cancer. Fortunately, efforts are underway to address these disparities.

Health benefits of anti-racisim strategies

Emerging research points to the potential for antiracism strategies to change the observed disparities.

A 2022 study published by the Journal of Clinical Oncology looked at the effects of an antiracism intervention on reducing racial disparities in lung cancer treatment.[]

Specifically, the researchers analyzed the proportion of patients who received surgery within 8 weeks of diagnosis.

The intervention took place at five cancer centers that participated in a study called Accountability for Cancer Care through Undoing Racism and Equity (ACCURE), an antiracism prospective pragmatic trial. A total of 2,363 patients with stage I and II non-small-cell lung cancer participated.

The intervention included three separate components. First, researchers used a real-time warning system to identify unmet care milestones. Second, they gathered race-specific feedback on lung cancer treatment rates. Finally, they implemented patient navigation.

The results were optimistic: 87.1% of Black patients and 85.4% of White patients in the intervention group underwent surgery within 8 weeks of getting their diagnosis. In the retrospective control group, only 58.7% of Black patients and 75% of White patients had the same outcome.

Antiracist interventions, the authors concluded, therefore created the opportunity for Black and White patients to get timelier surgery while effectively reducing the racial disparity in lung cancer treatment.

Physicians may take cues from ACCURE’s protocols in order to better care for patients of color with lung cancer, creating a more equitable landscape of care for all.

What this means for you

Patients of color with lung cancer have a 20% survival rate, which falls below the national survival rate of 25%. Individuals in this population are also less likely to receive an early diagnosis, as well as surgical treatment (or treatment of any kind) when compared with their White counterparts. In order to mitigate negative health outcomes among patients of color with lung cancer, you may introduce antiracism interventions to your practice. These may include a real-time warning system to identify care milestones that have gone unmet, as well as race-specific feedback on lung cancer treatment rates.

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