Diversity and Disparities in Lung Cancer Outcomes Among Minorities.

IF 2.6 4区 医学 Q3 ONCOLOGY Cancer journal Pub Date : 2023-11-01 DOI:10.1097/PPO.0000000000000689
Nyein Wint Yee Theik, Carlos Carracedo Uribe, Andres Alvarez, Meri Muminovic, Luis E Raez
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Abstract

Abstract: Because of diversities and disparities, lung cancer incidence and mortality rates among minorities are disproportionate compared with non-Hispanic White (NHW) populations. This review focuses on the disparities in lung cancer screening, diagnosis, treatment, and outcomes that minorities, mainly Hispanic and Black, experience compared with NHW populations. Despite efforts such as improving the eligibility criteria for screening to improve lung cancer survival rates, disparities persist, particularly among minority populations. However, the "Hispanic Paradox" describes the lower incidence and better survival rates observed in Hispanics compared with other ethnic groups best explained by possible contributions such as genetics and other factors such as dietary habits. Disparities in screening, particularly among underrepresented populations, are frequently explained by cultural, socioeconomic, and health care access barriers. There are also disparities in receiving appropriate treatment, such as surgical treatment, with fewer Hispanics and Blacks undergoing surgery than NHW individuals, resulting in lower overall survival rates. In addition, the prevalence of biomarker testing varies by racial and ethnic groups, influencing personalized treatment plans and outcomes. Finally, because of genetic and social determinants of health, the clinical outcomes of targeted therapy and immunotherapy may differ among minority populations. Identifying and addressing social determinants of health in real time are a "must" to have a significant impact in reducing lung cancer disparities. A comprehensive and multifaceted strategy is required to rectify disparities in cancer treatment. This strategy includes increasing levels of awareness and education, reducing financial and access barriers, and promoting increased diversity in clinical trial recruitment. By effectively addressing these complex challenges, the objective of providing equitable cancer care to all patients, regardless of race or ethnicity, can be achieved. To identify and address disparities, heightened awareness and education are essential. Access to health care is ensured by reducing financial and access barriers. Finally, increased diversity in clinical trial recruitment advances the generalizability of findings and promotes equitable representation of all racial and ethnic groups, resulting in improved outcomes for all patients.

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少数民族肺癌预后的多样性和差异。
摘要:由于多样性和差异,少数民族的肺癌发病率和死亡率与非西班牙裔白人(NHW)人群相比不成比例。本综述的重点是在肺癌筛查、诊断、治疗和结果方面的差异,少数民族,主要是西班牙裔和黑人,与NHW人群相比经历。尽管努力提高筛查的资格标准以提高肺癌存活率,但差距仍然存在,特别是在少数民族人群中。然而,“西班牙裔悖论”描述了西班牙裔与其他种族相比发病率更低、存活率更高的现象,最好的解释可能是遗传和饮食习惯等其他因素。筛查方面的差异,特别是在代表性不足的人群中,常常被解释为文化、社会经济和获得保健的障碍。在接受适当的治疗方面也存在差异,例如手术治疗,西班牙裔和黑人接受手术的人数少于非裔美国人,导致总体存活率较低。此外,生物标志物检测的流行程度因种族和民族而异,影响个性化的治疗计划和结果。最后,由于健康的遗传和社会决定因素,靶向治疗和免疫治疗的临床结果可能在少数民族人群中有所不同。要在减少肺癌差异方面产生重大影响,实时确定和处理健康的社会决定因素是“必须的”。要纠正癌症治疗方面的差距,需要一个全面和多方面的战略。这一战略包括提高认识和教育水平,减少资金和获取障碍,促进临床试验招募的多样化。通过有效地应对这些复杂的挑战,可以实现为所有患者提供公平的癌症护理的目标,无论种族或民族如何。要确定和解决差距,提高认识和教育至关重要。通过减少财政和获取障碍,确保获得保健服务。最后,临床试验招募的多样性提高了研究结果的普遍性,促进了所有种族和民族群体的公平代表,从而改善了所有患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cancer journal
Cancer journal 医学-肿瘤学
CiteScore
3.90
自引率
0.00%
发文量
102
审稿时长
7.5 months
期刊介绍: The Cancer Journal: The Journal of Principles & Practice of Oncology provides an integrated view of modern oncology across all disciplines. The Journal publishes original research and reviews, and keeps readers current on content published in the book Cancer: Principles & Practice of Oncology.
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