November is Lung Cancer Awareness Month. In this post, we'll be breaking down important information about lung cancer and highlighting the persistent racial disparities in lung cancer.
What is Lung Cancer?
Lung cancer is the third most common cancer in the U.S. and the leading cause of cancer deaths in the U.S6. The two most common types of lung cancer are non-small-cell lung cancer (NSCLC; 82%) and small-cell lung cancer (SCLC; 14%)2.
Symptoms of Lung Cancer
Treatment Options:
Surgery to remove part or all of the affected lung
Chemotherapy, a drug treatment that kills cancer cells and shrinks tumors
Immunotherapy
Targeted therapy
Radiation therapy
Prevention
Low-dose computed tomography (LDCT) is a new technology for lung cancer screening that has been crucial in reducing lung cancer mortality3. If detected early with proper screening methods, lung cancer can be cured5.
Lung Cancer in the U.S.
From 1997-2017, the incidence (new cases) rate for lung cancer was 59.2 per 100,000 persons for all population groups in the United States4. While the death rates of lung cancer have substantially declined in recent years due to significant advances in treatments and therapies, lung cancer still accounts for more than 22% of all cancer deaths in the U.S.1.
Racial Disparities in Lung Cancer
African-Americans have the highest lung cancer incidence (new cases) and mortality (death) rates of all racial & ethnic groups5. In 2016, lung cancer was the leading cause of death among African-American men and women5. Additionally, the incidence of lung cancer is 13% higher among Black men than White men4.
Source: Hunt & Balachandran, 2015
Disparities in Lung Cancer Survival:
Despite improvements in the last few decades, racial disparities in lung cancer survival persist. Black patients have lower survival from lung cancer, are less likely to receive surgical resection, chemotherapy, and/or radiation, and have a lower rate of accessing timely care than non-Hispanic Whites5.
Source: American Cancer Society
Factors Contributing to Disparities in Lung Cancer Among Whites and Blacks
1) The stage of cancer at diagnosis:
Black patients are more likely to seek care and be diagnosed at the advanced stage of the disease than White patients3. Diagnosis at the late stages of lung cancer often occurs because there are few symptoms in the early stages. Once diagnosed, Black patients have advanced-stage lung cancer and have higher mortality than other population groups5.
2) Treatment uptake:
Black patients are less likely to receive the standard of care for lung cancer than other racial groups4. Racial disparities in lung cancer treatment cause poor survival rates for Black lung cancer patients. Studies have shown that racial disparities in lung cancer are reduced to little or none when access to medical care and treatment is the same between Blacks and Whites3.
3) Underrepresentation of Blacks in clinical trials:
Black patients are underrepresented in clinical trials, making up 15% of cancer clinical trial enrollment in 2018-194. From 2020 to 2021, the FDA approved three new drugs to treat lung cancer. Black patients comprised less than 5% of clinical trial participants for each drug.
These differences in clinical trial enrollment between racial groups contribute to poorer outcomes for Black lung cancer patients due to underutilization of innovative targeted therapies, which have been shown to improve survival4.
Thus, one solution to overcoming disparities in lung cancer among Blacks and Whites is to ensure equal representation in medical research to address these differences in treatment uptake and clinical trial enrollment.
Please join Clinical Diversity Solutions as we gather the information needed to fight for the inclusion of communities of color in medical research on treatments for diseases that disproportionately affect our community. Complete our HIPPA-compliant survey today! Results are confidential, and a biostatistician will analyze the data!
References
Islami, F., Ward, E. M., Sung, H., Cronin, K. A., Tangka, F. K. L., Sherman, R. L., Zhao, J., Anderson, R. N., Henley, S. J., Yabroff, K. R., Jemal, A., & Benard, V. B. (2021). Annual Report to the Nation on the Status of Cancer, Part 1: National Cancer Statistics. JNCI: Journal of the National Cancer Institute, 113(12), 1648–1669. https://doi.org/10.1093/jnci/djab131
American Cancer Society. Cancer Facts & Figures 2022. Atlanta: American Cancer Society; 2022.
Hunt, B., & Balachandran, B. (2015). Black:White disparities in lung cancer mortality in the 50 largest cities in the United States. Cancer Epidemiology, 39(6), 908–916. https://doi.org/10.1016/j.canep.2015.10.003
Harrison, S., Judd, J., Chin, S., & Ragin, C. (2022). Disparities in Lung Cancer Treatment. Current Oncology Reports, 24(2), 241–248. https://doi.org/10.1007/s11912-022-01193-4
Sin, M. K. (2017). Lung cancer disparities and African-Americans. Public Health Nursing, 34(4), 359–362. https://doi.org/10.1111/phn.12335