TY - JOUR
T1 - Hispanics/Latinos in the Bronx Have Improved Survival in Non-Small Cell Lung Cancer Compared with Non-Hispanic Whites
AU - Klugman, Madelyn
AU - Xue, Xiaonan
AU - Ginsberg, Mindy
AU - Cheng, Haiying
AU - Rohan, Thomas
AU - Hosgood, H. Dean
N1 - Publisher Copyright:
© 2019, W. Montague Cobb-NMA Health Institute.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Background: Hispanics/Latinos are a growing yet understudied population in the United States (US). Despite lower socioeconomic status, Hispanics/Latinos tend to have similar or better health outcomes than Non-Hispanic Whites (NHWs). This phenomenon has not been conclusively studied for lung cancer. Methods: Using a cohort of patients at Montefiore Medical Center (MMC) in the Bronx, NY, we examined factors related to lung cancer survival by race/ethnicity with an emphasis on Hispanics/Latinos. Subjects were diagnosed with non-small cell lung cancer (NSCLC) between 2004 and 2017. Demographic and clinical data were obtained from MMC’s clinical systems and tumor-related information from MMC/Einstein’s Cancer Registry. Survival was assessed using Cox proportional hazards modeling adjusted for clinical and sociodemographic factors including smoking. Factors related to survival within each major racial/ethnic group were examined. Results: Hispanics/Latinos experienced decreased risk of death relative to NHWs [hazard ratio (HR) = 0.70, 95% confidence interval (95%CI) 0.57–0.86] overall and by sex (males: HR = 0.78, 95%CI 0.59–1.03, females: HR = 0.61, 95%CI 0.44–0.86). Decreased risk among Hispanics/Latinos relative to NHWs was evident in never-smokers (HR = 0.55, 95%CI 0.29–1.01), ever-smokers (HR = 0.72, 95%CI 0.57–0.90), younger subjects (HR = 0.73, 95%CI 0.54–0.99), and older subjects (HR = 0.72, 95%CI 0.53–0.97). Surgery was associated with improved survival in Hispanics/Latinos (HR = 0.60, 95%CI 0.43–0.85), and smoking with worse survival (HR = 1.56, 95%CI 1.02–2.39). Survival did not differ between Non-Hispanic Blacks and NHWs. Conclusions: In a poor urban community, Hispanics/Latinos experience improved survival from NSCLC compared to NHWs, which is not entirely explained by smoking. Future research should investigate the drivers of this benefit and differences in survival by Hispanic/Latino origin.
AB - Background: Hispanics/Latinos are a growing yet understudied population in the United States (US). Despite lower socioeconomic status, Hispanics/Latinos tend to have similar or better health outcomes than Non-Hispanic Whites (NHWs). This phenomenon has not been conclusively studied for lung cancer. Methods: Using a cohort of patients at Montefiore Medical Center (MMC) in the Bronx, NY, we examined factors related to lung cancer survival by race/ethnicity with an emphasis on Hispanics/Latinos. Subjects were diagnosed with non-small cell lung cancer (NSCLC) between 2004 and 2017. Demographic and clinical data were obtained from MMC’s clinical systems and tumor-related information from MMC/Einstein’s Cancer Registry. Survival was assessed using Cox proportional hazards modeling adjusted for clinical and sociodemographic factors including smoking. Factors related to survival within each major racial/ethnic group were examined. Results: Hispanics/Latinos experienced decreased risk of death relative to NHWs [hazard ratio (HR) = 0.70, 95% confidence interval (95%CI) 0.57–0.86] overall and by sex (males: HR = 0.78, 95%CI 0.59–1.03, females: HR = 0.61, 95%CI 0.44–0.86). Decreased risk among Hispanics/Latinos relative to NHWs was evident in never-smokers (HR = 0.55, 95%CI 0.29–1.01), ever-smokers (HR = 0.72, 95%CI 0.57–0.90), younger subjects (HR = 0.73, 95%CI 0.54–0.99), and older subjects (HR = 0.72, 95%CI 0.53–0.97). Surgery was associated with improved survival in Hispanics/Latinos (HR = 0.60, 95%CI 0.43–0.85), and smoking with worse survival (HR = 1.56, 95%CI 1.02–2.39). Survival did not differ between Non-Hispanic Blacks and NHWs. Conclusions: In a poor urban community, Hispanics/Latinos experience improved survival from NSCLC compared to NHWs, which is not entirely explained by smoking. Future research should investigate the drivers of this benefit and differences in survival by Hispanic/Latino origin.
KW - Epidemiology
KW - Ethnicity
KW - Lung
KW - Mortality
KW - Race
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U2 - 10.1007/s40615-019-00660-2
DO - 10.1007/s40615-019-00660-2
M3 - Article
C2 - 31713221
AN - SCOPUS:85075135926
SN - 2197-3792
VL - 7
SP - 316
EP - 326
JO - Journal of Racial and Ethnic Health Disparities
JF - Journal of Racial and Ethnic Health Disparities
IS - 2
ER -
