Association of social vulnerability on time-to-treatment for patients with non-small cell lung cancer

Jonathan E Williams; Faelan Jacobson-Davies; Ryan C Jacobs; Andrew C Chang; David D Odell

doi:10.1016/j.amjsurg.2025.116481

Association of social vulnerability on time-to-treatment for patients with non-small cell lung cancer

Am J Surg. 2025 Sep:247:116481. doi: 10.1016/j.amjsurg.2025.116481. Epub 2025 Jun 12.

Authors

Jonathan E Williams¹, Faelan Jacobson-Davies², Ryan C Jacobs³, Andrew C Chang⁴, David D Odell⁵

Affiliations

¹ Department of Surgery, University of Michigan. Ann Arbor, MI, USA; Center for Healthcare Outcomes and Policy, University of Michigan. Ann Arbor, MI, USA. Electronic address: willjona@med.umich.edu.
² Center for Healthcare Outcomes and Policy, University of Michigan. Ann Arbor, MI, USA.
³ Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁴ Department of Surgery, University of Michigan. Ann Arbor, MI, USA.
⁵ Department of Surgery, University of Michigan. Ann Arbor, MI, USA; Center for Healthcare Outcomes and Policy, University of Michigan. Ann Arbor, MI, USA.

PMID: 40570508
DOI: 10.1016/j.amjsurg.2025.116481

Abstract

Background: For patients with early-stage non-small cell lung cancer (NSCLC), treatment delays confer worse overall survival. The relationship between social vulnerability and time-to-treatment for NSCLC is unknown.

Methods: Using statewide cancer registry data, patients with localized (N0) NSCLC from 2015 to 2021 were identified. Social Vulnerability Index (SVI) was identified using patient place of residence. Using Poisson regression, the association of time-to-treatment and SVI was evaluated, with subgroup analyses stratifying by first treatment modality.

Results: 10,562 patients were included. Time-to-treatment increased in each subsequent SVI quartile. Compared to the lowest quartile, patients in the highest SVI quartile had longer adjusted time-to-treatment (64.6 vs 61.0 days, IRR 1.06 (95 % CI 1.05-1.07), p < 0.001). In subgroup analysis, patients in the highest quartile had longer time-to-treatment for all modalities.

Conclusions: NSCLC patients with higher social vulnerability demonstrate longer time-to-treatment, motivating further work addressing social determinants of health to maximize population-level access to timely lung cancer care.

Keywords: Lung cancer; Social vulnerability; Time-to-treatment.

MeSH terms

Aged
Carcinoma, Non-Small-Cell Lung* / mortality
Carcinoma, Non-Small-Cell Lung* / pathology
Carcinoma, Non-Small-Cell Lung* / therapy
Female
Humans
Lung Neoplasms* / mortality
Lung Neoplasms* / pathology
Lung Neoplasms* / therapy
Male
Middle Aged
Registries
Social Vulnerability*
Time-to-Treatment* / statistics & numerical data