BACKGROUND Treatment for lung cancer can improve prognosis, but 5-year survival remains low at 26%. An examination of treatment using data with higher population coverage, and among a broader number of treatment modalities and individual characteristics, would provide greater insight into differences in lung cancer treatment. RESEARCH QUESTION Among adults diagnosed with lung cancer, how does reported receipt of lung cancer treatment differ by sociodemographic characteristics? STUDY DESIGN AND METHODS We used 2015-2020 National Program of Cancer Registry data covering 89% of the US population to describe first-course treatment among persons ages ≥20 years diagnosed with lung and bronchus cancer. We performed multivariable logistic regression to examine associations between sociodemographic characteristics and treatment received. RESULTS Among 1,068,155 people diagnosed with lung cancer, 22% received surgery, 41% received chemotherapy, 40% received radiation, 13% received immunotherapy, and 75% received at least one of the four treatments. People who were ages >45 years (odds ratio [OR] range=0.08-0.67); American Indian or Alaska Native (OR=0.82; 95% CI: 0.77-0.87), Black (OR=0.82; 95% CI: 0.81-0.84), or Hispanic (OR=0.80; 95% CI: 0.78-0.82); resided in a non-metropolitan county (OR=0.98; 0.96-0.99); resided in the bottom 25% (OR=0.80; 95% CI: 0.78-0.81) and middle 50% (OR=0.87; 95% CI: 0.86-0.88) of counties by economic status (considers unemployment rate, per capita market income, and poverty rate); and in the West US census region (OR=0.95; 95% CI: 0.94-0.97) had significantly lower odds of receiving at least one of the four treatments. INTERPRETATION Chemotherapy and radiation were the most common types of first-course treatment reported. Receipt of at least one of the four treatments examined was lower among several groups, including certain racial and ethnic groups and those residing in counties with lower economic status. Future studies might further identify and intervene upon factors underlying differences.

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肺癌治疗的模式和差异 - 美国，2015-2020 年。


背景 肺癌治疗可以改善预后，但 5 年生存率仍然很低，为 26%。使用人口覆盖率更高的数据以及更广泛的治疗方式和个体特征来检查治疗，将更深入地了解肺癌治疗的差异。研究问题 在被诊断患有肺癌的成年人中，报告的接受肺癌治疗的经历如何因社会人口学特征而异？研究设计和方法我们使用 2015-2020 年国家癌症登记计划数据，涵盖 89% 的美国人口来描述被诊断患有肺癌和支气管癌的 ≥20 岁人群的首疗程治疗。我们进行了多变量 logistic 回归，以检查社会人口学特征与接受的治疗之间的关联。结果在 1,068,155 名被诊断患有肺癌的人中，22% 接受手术，41% 接受化疗，40% 接受放疗，13% 接受免疫治疗，75% 接受四种治疗中的至少一种。年龄 >45 岁的人 （比值比 [OR] 范围 = 0.08-0.67）;美洲印第安人或阿拉斯加原住民（OR=0.82;95% CI：0.77-0.87）、黑人（OR=0.82;95% CI：0.81-0.84）或西班牙裔（OR=0.80;95% CI：0.78-0.82）;居住在非大都会县 （OR=0.98;0.96-0.99）;按经济状况（考虑失业率、人均市场收入和贫困率）分布在县的后 25%（OR=0.80;95% CI：0.78-0.81）和中间 50%（OR=0.87;95% CI：0.86-0.88）;在美国西部人口普查区 （OR=0.95;95% CI： 0.94-0.97） 接受四种治疗中至少一种的几率显著降低。解释 化疗和放疗是报道的最常见的首疗程治疗类型。 在几个群体中，包括某些种族和族裔群体以及居住在经济地位较低县的人，接受所检查的四种治疗中至少有一种的接受率较低。未来的研究可能会进一步确定和干预潜在差异的因素。