Racial Disparities in Follow-Up Care of Early-Stage Lung Cancer Survivors

The importance of follow-up care and surveillance among lung cancer survivors in the management of treatment- and disease-related symptoms as well as early detection of cancer recurrence is well-established. The current cross-sectional study sought to evaluate racial disparities in the delivery of follow-up care among lung cancer survivors.

The study enrolled survivors of early-stage non–small-cell lung cancer (NSCLC) from the New Jersey State Cancer Registry. Enrolled participants must have had surgery for stage I or II NSCLC between 2014 and 2017 and completed all treatment at least 1 year prior to enrollment. Eligible participants were administered a questionnaire that included topics relating to demographics, smoking, cancer history and treatment, quality of life, follow-up care, barriers to care, and informational needs.

A total of 482 survivors were identified and contacted; of these, 23.9% (n = 115) completed and returned the survey. Of the 112 evaluable participants, 78 (70%) were non-Hispanic whites and 34 (30%) were non-Hispanic blacks; the majority were female (61%) and were in remission (92%). A significantly lower proportion of black participants received a follow-up scan compared with white participants (70% vs 89%; P = .02). A significantly lower proportion of black participants reported receiving follow-up care information from their provider compared with white participants (71% vs 94%; P <.005). There were no differences between black and white participants in terms of receiving a written treatment summary (55% vs 58%), following up with a physician within the past year (93% vs 87.5%), and receiving age-appropriate regular colon (69% vs 65%) and breast cancer (81% vs 80%) screening. A higher percentage of black participants reported current smoking status compared with white participants (25% vs 12%). For both black and white participants, financial concerns relating to out-of-pocket costs, noncoverage of tests, and lack of insurance were the most significant barriers to care.

These results indicate that significant racial disparities exist among lung cancer survivors in terms of receipt of surveillance scans and guidance about follow-up care and smoking cessation, highlighting the need for targeted interventions to eliminate these disparities.

Source: Malhotra J, et al. J Clin Oncol. 2021;39(suppl 15):Abstract 12025.