The effect of race on patterns of care and utilization of palliative interventions in patients with lung cancer

Abstract Purpose Black patients in the US are disproportionately affected by lung cancer. National surveys evidence that black patients and their families are less satisfied with the quality of palliative care received. This necessitates investigating the impact and outcome of its use for minority patients. Methods This retrospective study included patients treated for lung cancer at a single academic center between 2012–2022. Demographics, insurance status, comorbidities, treatment strategies, and cancer survival outcomes were analyzed. Results Altogether 2,048 (1,660 white and 388 black) patients were included in the study with other races excluded due to low sample sizes. Black patients were younger, more male, had higher rates of current tobacco use, and utilized Medicaid more often than their white counterparts. Black patients also had more comorbidities while having less family history of cancer, were diagnosed with more advanced stages of cancer, and had more active cancer status in follow-up. They also received palliative care at almost twice the rate of white patients. While black patients had significantly poorer survival overall ( p = 0.007), race was insignificant in a multivariable analysis ( p = 0.240). However, factors such as insurance, type of cancer, type of care received, and cancer stage were found to be significant predictors of death. Conclusion While overall survival seemed poorer for black patients, race was not a predictor of mortality in multivariable analysis. Encouragingly, black patients received palliative care at almost twice the rate of white patients. Further research is needed to ensure comprehensive screening for early diagnosis in minority patients.