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Miles McAllister
Pronouns
She/her
Rank
Resident
Institution
Brigham and Women's Hospital
Department
Surgery
Authors
Anupama Singh, Yue Xie, Miles A. McAllister, Emanuele Mazzola, Fatemehsadat Pezeshkian, Michael T. Jaklitsch, Fatima Wilder
Principal Investigator
Categories:
Objective: Younger female patients are increasingly diagnosed with lung cancer. We sought to evaluate the impact of age, race, and sex on surgical management of NSCLC.
Methods: We retrospectively analyzed patients diagnosed with NSCLC from 2004-2018 in the Southern Community Cohort Study (SCCS) database, which encompasses one of the largest percentages of minority patients (~70%). Patients were stratified into Black vs. White and 55 years (B). Treatment variables were tabulated, and Kaplan-Meier curves estimated overall survival.
Results: In total, 1474 patients were included: 924 (63%) Black and 705 (48%) females. Encompassing all ages, fewer Black females (16%) were diagnosed with stage I disease compared to White females (23%) (P=0.02). Black females underwent surgery less often than White females (80% vs. 65%, P=0.002), and even when they did, Black females more often received inadequate lymphadenectomy (75% vs. 65%, P=0.02). Stratifying by age, fewer younger Black females (A) compared to older Black females (B) were stage I (11% vs. 18%, P=0.721), more underwent inadequate lymphadenectomy (81% vs. 74%, P=0.08), and more didn’t receive surgery (84% vs. 80%, P=0.649). When comparing younger (A) and older (B) White females, the former were diagnosed more often diagnosed with stage I (27% vs. 25%, P=0.253), received inadequate lymphadenectomy (63% vs. 65%, P=0.367), and underwent surgery less often (52% vs. 68%, P=0.114). Survival among females who underwent surgical resection did not differ based on race or age.
Conclusions: There is limited data on the complex interactions between race, age, and female sex on management of NSCLC. Our data highlights persistent disparities between Black and White females. Additionally, although not statistically significant, there is a trend towards younger female patients more often receiving inadequate management of their cancer, particularly among young Black females. However, when patients did receive appropriate management, survival was comparable.
