SOCIAL-FACTORS, TREATMENT, AND SURVIVAL IN EARLY-STAGE NONSMALL CELL LUNG-CANCER

Objectives. This study assessed the importance of socioeconomic status , race, and likelihood of receiving surgery in explaining mortality am ong patients with stage-I non-small cell lung cancer. Methods. Analyse s 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 lu ng cancer in Detroit, San Francisco, and Seattle. The main outcome mea sure was months of survival after diagnosis. Results. Patients in the highest income decile were 45% more likely to receive surgical treatme nt and 102% more likely to attain 5-year survival than those in the lo west decile. Whites were 20% more likely to undergo surgery than Black s and 31% more likely to survive 5 years. Multivariate procedures cont rolling for age and sex confirmed these observations. Conclusions. Soc ioeconomic status and race appear to independently influence likelihoo d of survival. Failure to receive surgery explains much excess mortali ty.