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UNC study helps explain why black patients with lung cancer have surgery less often than whites
Date:6/15/2010

when they don't fully understand their prognosis or challenge a clinical decision against surgery that was not based on absolute contraindications complicating conditions that are considered to make surgery inadvisable.

In Cykert's prospective cohort study, he and colleagues analyzed data from 386 lung cancer patients from five communities in North and South Carolina who met full eligibility criteria for lung resection surgery. Each participant, at the time of diagnosis, verbally completed a 106-item survey at the time of enrollment that included questions about their demographics (race, age, sex, income, etc.), perceptions of patient-physician communication, perceived certainty of diagnosis, attitudes about lung cancer, religiosity, past health care experiences, access to a regular source of care (such as a primary care doctor) and their medical decision makers (such as a spouse, child or spiritual advisor).

In addition, researchers reviewed the medical charts of each patient four months after enrollment. Information collected from the chart review included the date of lung cancer surgery (if performed) and pathological diagnosis, preoperative stage, medical comorbidities and preoperative lung function results. The primary outcome they were looking for was whether or not the patient received lung cancer surgery within four months of study enrollment.

The results show that 66 percent of white patients had surgery, compared to 55 percent for black patients. Surgical rates for blacks were especially low when they had two or more comorbid illnesses or lacked a regular source of care. For blacks with two or more comorbidities, the surgical rate was 13 percent, compared to 62 percent among black patients without comorbidities. When blacks lacked a regular source of care, their surgical rate was 42 percent, compared to 57 percent for blacks with regular care.

These results suggest that there may be thousands of black patients with lun
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Contact: Tom Hughes
tahughes@unch.unc.edu
919-966-6047
University of North Carolina School of Medicine
Source:Eurekalert

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