• Apar Kishor Ganti, Shanmuga P Subbiah, Anne Kessinger, Wilson I Gonsalves, Peter T Silberstein, and Fausto R Loberiza.
• Department of Internal Medicine, VA Nebraska Western Iowa Health Care System, Omaha, NE; Division of Oncology/Hematology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE. Electronic address: aganti@unmc.edu.
• Clin Lung Cancer. 2014 Mar 1; 15 (2): 152-8.

BackgroundRacial disparities in outcomes of non-small-cell lung cancer (NSCLC) patients in the United States are well documented. A retrospective analysis of patients in the Veterans Affairs Central Cancer Registry was conducted to determine whether similar disparities exist in a population with a single-payer, accessible health care system.Patients And MethodsDemographic data of patients diagnosed with NSCLC between January 1995 and February 2009 were analyzed using Kruskal-Wallis test or the χ(2) test. Multivariate Cox proportional hazards regression analysis was used to compare survival among races.ResultsOf the 82,414 patients, 98% were male, 82% had a smoking history, and 81% were Caucasian. Caucasian individuals had better prognostic features compared with African-American individuals (stage I/II [24% vs. 21%]; Grade I/II [21% vs. 17%]). A larger proportion of Caucasian compared with African-American individuals received stage-appropriate treatment (surgery for stage I [48% vs. 41%; P < .001]; chemotherapy for stage IV [18% vs. 16%; P = .003]). African-American individuals had a lower risk of mortality compared with Caucasian individuals (hazard ratio, 0.94; 95% confidence interval, 0.92-0.96).ConclusionAlthough African-American patients had a higher stage and grade of NSCLC, they had a better overall survival than Caucasian patients. In a single-payer system with accessible health care, previously described racial differences in lung cancer outcomes were not observed.Published by Elsevier Inc.

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