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VA Provides Racially Equitable Lung Cancer Care

by U.S. Medicine

November 6, 2013

DURHAM, NC –  The VA healthcare system is providing racially equitable care in terms of time to initiation of treatment and referral to supportive care for lung cancer patients, according to a new analysis.1

Researchers from the Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, in Durham, NC, noted that the “small racial difference in survival time of approximately two weeks is not clinically meaningful,” calling for future studies to “validate this possible trend prospectively, with longer periods of follow-up, in other veteran groups.”

Background in the article, which was published in the journal Cancer Management and Research, stated that non-small cell lung cancer is the leading cause of cancer-related mortality in the United States, with patients in the late stages having five-year survival rates of only 2% to 15%. Time to receiving recommended care and survival are measures of care quality.

For the study, researchers used data from the External Peer Review Program, a nationwide VA quality-monitoring program, focusing on Caucasian or African American patients with pathologically confirmed late-stage non-small cell lung cancer in 2006 and 2007. Three quality measures were examined: (1) treatment initiation, (2) palliative care or hospice referral, and (3) death.

Study authors report that, after controlling for patient and disease characteristics, there were no racial differences in time to initiation of treatment (72 days for African-American vs. 65 days for Caucasian patients, hazard ratio 1.04, P = 0.80) or palliative care or hospice referral (129 days vs. 116 days, hazard ratio 1.10, P = 0.34).

The adjusted model, however, found longer survival for African-American patients than for Caucasian patients (133 days vs. 117 days, hazard ratio 0.31, P < 0.01).

  1. Zullig LL, Carpenter WR, Provenzale DT, Weinberger M, Reeve BB, Williams CD, Jackson GL. The association of race with timeliness of care and survival among Veterans Affairs health care system patients with late-stage non-small cell lung cancer. Cancer Manag Res. 2013 Jul 24;5:157-63. doi: 10.2147/CMAR.S46688. Print 2013. PubMed PMID: 23900515; PubMed Central PMCID: PMC3726302.

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