PQA 02 - Lung Cancer/Thoracic Malignancies, Patient Reported Outcomes/QoL/Survivorship, Pediatric Cancer
Presenter(s)
P. L. Wilson1, M. Petereit2, L. Kroboth2, C. Joshu3, J. Gunville-Porter3, K. Nelson3, K. Ulmer4, M. Sargent5, K. Cina5, A. Kelliher3, D. Warne3, and D. G. Petereit6; 1University of Minnesota, Minneapolis, MN, 2University of South Dakota, Vermillion, SD, 3Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 4University of Iowa, Iowa City, IA, 5Walking Forward Avera, Rapid City, SD, 6Regional Cancer Care Institute, Rapid City, SD
Purpose/Objective(s):
Northern Plains American Indians (AI) suffer the highest lung mortality rates in the US, and younger age at death compared to non-indigenous (non-AI) populations within the same region.[1] Further analysis is needed to define specific treatment related comparisons between AI and non-AI populations within the Northern Plains region.
Materials/Methods:
A retrospective chart review was performed utilizing detailed tumor registry records from a comprehensive cancer center located within the Northern Great Plains region. Individuals were grouped based on AI and non-AI status. Relevant demographic, social, and treatment related events were recorded and compared between the two groups utilizing t-test for continuous variables and chi-square test for categorical variables.
Results:
The analysis included 158 AI individuals and 139 non-AI individuals. In the AI group, 57.6% were female, and the mean age at diagnosis was 67.8 years, compared to 47.5% female and 69.9 years in the non-AI group (p = 0.08). Smoking rates were similar, with 96.2% of AI and 91.4% of non-AI individuals being current or former smokers. A significantly lower proportion of AI individuals had private insurance (17.7% vs. 60.4%, p < 0.001). Symptomatic presentation occurred in 75.3% of AI individuals versus 69.1% of non-AI individuals (p = 0.001). Initial disease detection via LDCT was 1.3% in the AI group compared to 2.2% in the non-AI group (p = 0.01), while incidental detection on other imaging was 12.7% vs. 23.7% respectively (p < 0.01). The AI group had a higher percentage of untreated individuals (26.6% vs. 18.7%) and a lower percentage receiving curative treatment (32.3% vs. 38.1%; p=0.01). Among treated patients, 32.8% of AI individuals received radiation alone compared to 25.5% of non-AI individuals, while 2.6% vs. 12.3% received immunotherapy respectively. The time from symptom onset to diagnosis was similar (2.6 vs. 2.4 months), but AI individuals had longer times from symptom onset to treatment (4.8 vs. 3.0 months, p < 0.01) and from diagnosis to treatment (1.7 vs. 0.83 months, p < 0.01).
Conclusion:
The disparities in social, demographic, and treatment-related metrics and outcomes for lung cancer within our study population stem from a complex interplay of factors. To mitigate these high mortality rates, a comprehensive, multidisciplinary approach will be essential to enhance lung cancer screening and treatment outcomes among the Northern Plains AI population.
