A system-based intervention to reduce Black-White disparities in the treatment of early stage lung cancer: A pragmatic trial at five cancer centers
- ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)
- Samuel,Eng,Eugenia,Walker,Paul,Manning,Matthew A.,Robertson,Linda B.,Arya,Rohan,Jones,Nora S.,Her Cykert (Creator)
- Institution
- East Carolina University (ECU )
- Web Site: http://www.ecu.edu/lib/
Abstract: Background: Advances in early diagnosis and curative treatment have reduced highmortality rates associated with non-small cell lung cancer. However, racial disparityin survival persists partly because Black patients receive less curative treatment thanWhite patients.Methods: We performed a 5-year pragmatic, trial at five cancer centers using a system-based intervention. Patients diagnosed with early stage lung cancer, aged 18-85were eligible. Intervention components included: (1) a real-time warning system derived from electronic health records, (2) race-specific feedback to clinical teams ontreatment completion rates, and (3) a nurse navigator. Consented patients were compared to retrospective and concurrent controls. The primary outcome was receipt ofcurative treatment.Results: There were 2841 early stage lung cancer patients (16% Black) in the retrospective group and 360 (32% Black) in the intervention group. For the retrospectivebaseline, crude treatment rates were 78% for White patients vs 69% for Black patients (P < 0.001); difference by race was confirmed by a model adjusted for age,treatment site, cancer stage, gender, comorbid illness, and income-odds ratio (OR)0.66 for Black patients (95% CI 0.51-0.85, P = 0.001). Within the intervention cohort, the crude rate was 96.5% for Black vs 95% for White patients (P = 0.56). Oddsratio for the adjusted analysis was 2.1 (95% CI 0.41-10.4, P = 0.39) for Black vsWhite patients. Between group analyses confirmed treatment parity for theintervention.Conclusion: A system-based intervention tested in five cancer centers reduced racialgaps and improved care for all.
Additional Information
- Publication
- Other
- Language: English
- Date: 2019
- Keywords
- cancer disparities, health equity, intervention, pragmatic trial, systems change
| Title | Location & Link | Type of Relationship |
| A system-based intervention to reduce Black-White disparities in the treatment of early stage lung cancer: A pragmatic trial at five cancer centers | http://hdl.handle.net/10342/7839 | The described resource references, cites, or otherwise points to the related resource. |