Samuel Cykert|Eugenia Eng|Paul R. Walker|Matthew Manning|Linda Robertson|Rohan Arya|Nora Jones|Dwight E. Heron
A system?based intervention to reduce Black?White disparities in the treatment of early stage lung cancer: A pragmatic trial at five cancer centers
University of North Carolina at Chapel Hill|East Carolina University|Cone Health|UPMC Hillman Cancer Center|University of South Carolina|UPMC Hillman Cancer Center
advances early diagnosis curative treatment reduced high mortality rates associated nonsmall cell lung cancer however racial disparity survival persists partly black patients receive less curative treatment white patientswe performed 5year pragmatic trial five cancer centers using systembased intervention patients diagnosed early stage lung cancer aged 1885 eligible intervention components included 1 realtime warning system derived electronic health records 2 racespecific feedback clinical teams treatment completion rates 3 nurse navigator consented patients compared retrospective concurrent controls primary outcome receipt curative treatmentthere 2841 early stage lung cancer patients 16 black retrospective group 360 32 black intervention group retrospective baseline crude treatment rates 78 white patients vs 69 black patients p 0001 difference race confirmed model adjusted age treatment site cancer stage gender comorbid illness incomeodds ratio 066 black patients 95 ci 051085 p 0001 within intervention cohort crude rate 965 black vs 95 white patients p 056 odds ratio adjusted analysis 21 95 ci 041104 p 039 black vs white patients group analyses confirmed treatment parity interventiona systembased intervention tested five cancer centers reduced racial gaps improved care