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Intervention Can Reduce Racial Differences in Lung Cancer Care

THURSDAY, Feb. 28, 2019 — An intervention that includes race-specific feedback and real-time electronic warnings can reduce racial differences in care for early-stage lung cancer, according to a study published online Feb. 4 in Cancer Medicine.

Samuel Cykert, M.D., from the University of North Carolina School of Medicine in Chapel Hill, and colleagues evaluated a system-based intervention (a real-time warning system derived from electronic health records, race-specific feedback to clinical teams on treatment completion rates, and a nurse navigator) at five cancer centers treating patients diagnosed with early-stage lung cancer. The patients in the intervention group were compared to retrospective and concurrent controls.

The researchers found that among the 2,841 early-stage lung cancer patients (16 percent black) in the retrospective group, crude treatment rates were 78 percent for white patients versus 69 percent for black patients (P < 0.001), with confirmation of a racial difference after adjustment for age, treatment site, cancer stage, gender, comorbid illness, and income (adjusted odds ratio, 0.66 for black patients; P = 0.001). Among the 360 patients (32 percent black) in the intervention group, the crude treatment rate was 96.5 percent for black versus 95 percent for white patients (P = 0.56). Between-group analyses confirmed treatment parity for the intervention.

“Application of this system-based, pragmatic approach to other cancer treatment disparities at a health system level could have positive effects on treatment completion, treatment equity, and overall outcomes,” the authors write.

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Posted: February 2019

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