The association of race with timeliness of care and survival among Veterans Affairs health care system patients with late-stage non-small cell lung cancer

Figures & data

Table 1 Description of NSCLC patient cohort and key variables

	Caucasian patients (N = 1,826), % (N) or mean (SD)	African American patients (N = 374), % (N) or mean (SD)	Full sample (N = 2,200), % (N) or mean (SD)
Dependent variables
Days from diagnosis to initiation of treatmenta	64.9 (84.2)	71.5 (89.8)	66.0 (85.2)
Days from diagnosis to referral to palliative care or hospice	115.5 (102.5)	129.4 (108.1)	117.8 (103.6)
Days from diagnosis to death	116.8 (92.0)	132.9 (100.5)	119.5 (93.7)
Independent variable
Caucasian race	100.0% (1826)	0.0% (374)	83.0% (1826)
Other control variables
Age at diagnosis
<55 years	7.0% (127)	12.3% (46)	7.9% (173)
55–64 years	32.7% (597)	36.9% (138)	33.4% (735)
65–74 years	26.0% (475)	23.8% (89)	25.6% (564)
≥75 years	27.2% (496)	21.4% (80)	26.2% (576)
Married	47.5% (866)	35.4% (132)	45.5% (998)
Region
South	43.8% (799)	62.0% (232)	46.9% (1031)
North	13.3% (243)	10.2% (38)	12.8% (281)
Central	23.4% (428)	16.0% (60)	22.2% (488)
West	19.5% (356)	11.8% (44)	18.2% (400)
Stage at diagnosis
Stage 3	11.3% (206)	12.6% (47)	11.5% (253)
Stage 4	88.7% (1620)	87.4% (327)	88.5% (1947)
Poor performance statusb	65.0% (1186)	64.4% (241)	64.9% (1427)

Notes:

a Treatment included initiation of lung cancer surgery, chemotherapy, radiation therapy, admission into palliative care, or admission into hospice;

b patients were considered to have poor performance if the medical record contained documentation of an Eastern Cooperative Oncology Group score >2, a Karnofsky Performance Status Scale score of <60%, or an Adult Comorbidity Evaluation-27 score of 2 (moderate) or 3 (severe).

Abbreviations: NSCLC, non-small cell lung cancer; N, number; SD, standard deviation.

Figure 1 Lung cancer cohort assembly.

Abbreviations: EPRP, External Peer Review Program; N, number; VACCR, Veterans Affairs Central Cancer Registry; NSCLC, non-small cell lung cancer.

Table 2 Cox proportional hazard model regression results

	Diagnosis to treatment initiationa			Diagnosis to referral to palliative care or hospice			Diagnosis to death
	HR	95% CI	P-value	HR	95% CI	P-value	HR	95% CI	P-value
Demographic characteristics
Caucasian race	1.04	0.78–1.37	0.80	1.10	0.91–1.34	0.34	0.31	1.14–1.50	<0.01*
Married	1.00	0.81–1.25	0.98	1.02	0.88–1.12	0.78	0.89	0.81–0.99	0.02*
Age at diagnosis
<55 years	0.82	0.56–1.22	0.34	0.83	0.63–1.10	0.19	0.76	0.62–0.92	0.01*
55–64 years	0.97	0.75–1.27	0.83	0.90	0.75–1.09	0.27	0.89	0.80–1.00	0.06
65–74 years	1.04	0.79–1.37	0.79	0.99	0.82–1.20	0.92	0.88	0.78–1.00	0.06
≥ 75 years (reference)
Region
North	1.02	0.71–1.46	0.92	0.87	0.67–1.13	0.29	1.10	0.95–1.28	0.19
Central	0.89	0.67–1.18	0.40	0.89	0.73–1.08	0.24	1.13	1.00–1.27	0.06
West	0.87	0.64–1.17	0.36	0.96	0.78–1.18	0.69	1.08	0.95–1.24	0.23
South (ref)
Poor performance status	0.81	0.64–1.03	0.09	0.81	0.69–0.95	0.01*	0.80	0.72–0.89	<0.01*
Stage at diagnosis
Stage 3	0.87	0.59–1.28	0.47	1.37	1.13–1.64	<0.01*	0.53	0.45–0.63	<0.01*
Stage 4 (ref)
N	2,098			2,149			2,190

Notes:

a First treatment could have been chemotherapy, radiation therapy, or admission to palliative care or hospice;

* indicates statistical significance at the <0.05 alpha level.

Abbreviations: HR, hazard ratio; CI, confidence interval; N, number.