Social factors, treatment, and survival in early-stage non-small cell lung cancer

Am J Public Health. 1998 Nov;88(11):1681-4. doi: 10.2105/ajph.88.11.1681.


Objectives: This study assessed the importance of socioeconomic status, race, and likelihood of receiving surgery in explaining mortality among patients with stage-I non-small cell lung cancer.

Methods: Analyses focused on Black and White individuals 75 years of age and younger (n = 5189) diagnosed between 1980 and 1982 with stage-I non-small cell lung cancer in Detroit, San Francisco, and Seattle. The main outcome measure was months of survival after diagnosis.

Results: Patients in the highest income decile were 45% more likely to receive surgical treatment and 102% more likely to attain 5-year survival than those in the lowest decile. Whites were 20% more likely to undergo surgery than Blacks and 31% more likely to survive 5 years. Multivariate procedures controlling for age and sex confirmed these observations.

Conclusions: Socioeconomic status and race appear to independently influence likelihood of survival. Failure to receive surgery explains much excess mortality.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • African Americans / statistics & numerical data*
  • Aged
  • Carcinoma, Non-Small-Cell Lung / mortality*
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • Humans
  • Income / statistics & numerical data*
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / surgery*
  • Male
  • Michigan
  • Middle Aged
  • Multivariate Analysis
  • Patient Selection
  • SEER Program
  • San Francisco
  • Socioeconomic Factors
  • Survival Analysis
  • Washington