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Study examines reasons patients with early stage lung cancer do not have surgery
Date:6/15/2010

Despite a greater likelihood of poorer outcomes, many patients newly-diagnosed with early-stage lung cancer do not undergo surgery. New research indicates that among the factors associated with this decision include misunderstandings of the prognosis, negative perceptions of patient-physician communication and older age, with black patients more likely to not have surgery, according to a study in the June 16 issue of JAMA.

Lung cancer is the leading cause of cancer death in the United States. "Surgical resection for stage I or II non-small cell cancer remains the only reliable treatment for cure. Patients who do not undergo surgery have a median [midpoint] survival of less than 1 year. Despite the survival disadvantage, many patients with early-stage disease do not receive surgical care and rates are even lower for black patients," the authors write.

Samuel Cykert, M.D., of the Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, N.C., and colleagues conducted a study among newly diagnosed patients with early-stage lung cancer to identify potentially modifiable factors regarding undergoing surgery and to explore why black patients have this surgery less than white patients. The study included 437 patients with biopsy-proven or probable early-stage lung cancer, who were enrolled between December 2005 and December 2008. Before determining treatment plans, patients were administered a survey including questions about trust, patient-physician communication, attitudes toward cancer and functional status. Information about co-existing illnesses was obtained through examination of charts. A total of 386 patients met eligibility criteria for lung resection surgery. The median age was 66 years and 29 percent of patients were black. Two hundred forty-one patients (62 percent) had lung cancer surgery within 4 months of diagnosis (179/273 white patients [66 percent] vs. 62/113 black patients [55 percent]).
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Contact: Tom Hughes
tahughes@unch.unc.edu
919-966-6047
JAMA and Archives Journals
Source:Eurekalert

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