Disparities in Thoracic Oncology Patients

TL;DR

This paper reviews how social, economic, and geographic factors contribute to unequal lung cancer outcomes and highlights the need for equitable healthcare access.

Contribution

The paper synthesizes existing research to identify the root causes of disparities in lung cancer care and proposes actionable solutions for equitable treatment.

Findings

Racial and ethnic minorities, low-income individuals, and rural populations face higher lung cancer burdens and worse outcomes.

Unequal access to screening, treatment, and clinical trials contributes to disparities in lung cancer survival.

Following guidelines can lead to similar survival outcomes across different demographic groups.

Abstract

Lung cancer continues to be a predominant cause of cancer-related mortality globally; however, not all individuals experience equal advantages from advancements in screening, diagnosis, and treatment. Countless individuals from underprivileged backgrounds face elevated risks, delayed diagnoses, and worse access to adequate healthcare, resulting in adverse consequences. This review aimed to elucidate the impact of social, economic, racial, and geographic determinants on lung cancer along the continuum of care, encompassing risk exposure, early detection, treatment, and survival outcomes. The authors intend to consolidate existing research to elucidate the locations and reasons for these inequalities and their impact on patient outcomes. The results underscore that enhancing lung cancer survival necessitates not only medical advancements but also equitable access to screening, prompt diagnosis, effective treatment, and involvement in research. This study may inform future research, policy, and healthcare practices aimed at achieving equitable lung cancer care for all demographics.

Background/Objectives: Lung cancer is one of the major causes of mortality worldwide despite breakthroughs in screening, diagnosis, and treatment. These advances have not been evenly spread, and discrepancies between populations remain concerning. This article examines lung cancer discrepancies in epidemiology, risk factors, screening, diagnosis, treatment access and quality, and survival outcomes, and identifies the main causes. Methods: An extensive narrative evaluation of peer-reviewed literature, national cancer surveillance reports, and large population-based research was searched. The evidence on lung cancer disparities by race, ethnicity, socioeconomic status, sex, geography, and healthcare access was synthesized. Disparities in prevention, early identification, treatment, and outcomes were organized into this paper. Results: Lung cancer incidence, stage, treatment, and survival showed persistent differences. Racial and ethnic minority groups, people on low-incomes, uninsured people, and rural or resource-limited people had higher disease burden and worse outcomes. Access to low-dose computed tomography screening, rapid diagnostic follow-up, surgical resection, molecular testing, targeted medicines, immunotherapy, palliative care, and clinical trials was unequal. When guidelines are followed, survival outcomes are similar across races and ethnicities. Conclusions: Lung cancer disparities are mostly caused by structural, social, and healthcare system factors, not biology. Coordinated measures to provide equitable screening, prompt and high-quality treatment, research inclusion, and culturally sensitive and policy-driven actions are needed to enhance lung cancer outcomes.

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