Dataset Information

County-Level Variations in Receipt of Surgery for Early-Stage Non-small Cell Lung Cancer in the United States.

ABSTRACT:

Background

Although counties are the smallest geographic level for comprehensive health-care delivery analysis, little is known about county-level variations in receipt of curative-intent surgery for early-stage non-small cell lung cancer (NSCLC) and factors contributing to such variations in the United States.

Methods

A total of 179,189 patients aged ? 35 years who were diagnosed with stage I to II NSCLC between 2007 and 2014 in 2,263 counties were identified from 39 states, the District of Columbia, and Detroit population-based cancer registries; the data were compiled by the North American Association of Central Cancer Registries. The percentage of patients who underwent surgery was calculated for each county with ? 20 cases. Adjusted risk ratios were generated by using generalized estimating equation models with modified Poisson regression.

Results

Receipt of surgery for early-stage NSCLC during 2007 to 2014 according to county ranged from 12.8% to 48.6% in the lowest decile of counties, to 74.3% to 91.7% in the highest decile of counties. There were pockets of low surgery receipt rate counties within each state. For example, there was a 25% absolute difference between the lowest and highest surgery receipt rate counties in Massachusetts. Counties in the lowest quartile for receipt of surgery were those with a high proportion of non-Hispanic black subjects, high poverty and uninsured rates, low surgeon-to-population ratio, and nonmetropolitan status.

Conclusions

Receipt of curative-intent surgery for early-stage NSCLC varied substantially across counties in the United States, with pockets of low receipt counties in each state. Low surgery receipt counties were characterized by unfavorable area-level socioeconomic and health-care delivery factors.

SUBMITTER: Sineshaw HM

PROVIDER: S-EPMC6965692 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

County-Level Variations in Receipt of Surgery for Early-Stage Non-small Cell Lung Cancer in the United States.

Sineshaw Helmneh M HM Sahar Liora L Osarogiagbon Raymond U RU Flanders W Dana WD Yabroff K Robin KR Jemal Ahmedin A

Chest 20191205 1

<h4>Background</h4>Although counties are the smallest geographic level for comprehensive health-care delivery analysis, little is known about county-level variations in receipt of curative-intent surgery for early-stage non-small cell lung cancer (NSCLC) and factors contributing to such variations in the United States.<h4>Methods</h4>A total of 179,189 patients aged ≥ 35 years who were diagnosed with stage I to II NSCLC between 2007 and 2014 in 2,263 counties were identified from 39 states, the ...[more]

PMID: 31813533

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Dataset Information

County-Level Variations in Receipt of Surgery for Early-Stage Non-small Cell Lung Cancer in the United States.

Background

Methods

Results

Conclusions

Publications

County-Level Variations in Receipt of Surgery for Early-Stage Non-small Cell Lung Cancer in the United States.

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