Samuel Cykert
Factors Associated With Decisions to Undergo Surgery Among Patients With Newly Diagnosed Early-Stage Lung Cancer
lung cancer leading cause cancer death united states surgical resection stage ii nonsmall cell cancer remains reliable treatment cure patients undergo surgery median survival less 1 year despite survival disadvantage many patients earlystage disease receive surgical care rates even lower black patientsto identify potentially modifiable factors regarding surgery patients newly diagnosed earlystage lung cancer explore blacks undergo surgery less often whitesprospective cohort study patients identified pulmonary oncology thoracic surgery generalist practices 5 communities study referral computerized tomography review protocol total 437 patients biopsyproven probable earlystage lung cancer enrolled december 2005 december 2008 establishment treatment plans patients administered survey including questions trust patientphysician communication attitudes toward cancer functional status information comorbid illnesses obtained chart auditslung cancer surgery within 4 months diagnosisa total 386 patients met full eligibility criteria lung resection surgery median age 66 years range 2690 years 29 patients black surgical rate 66 white patients n 179273 compared 55 black patients n 62113 p 05 negative perceptions patientphysician communication manifested 5point decrement 25point communication scale odds ratio 042 95 confidence interval ci 032074 negative perception 1year prognosis postsurgery 027 95 ci 014050 absolute risk 34 associated decisions surgery surgical rates blacks particularly low 2 comorbid illnesses 13 vs 62 2 comorbidities 004 95 ci 001025 absolute risk 49 blacks lacked regular source care 42 regular care vs 57 regular care 020 95 ci 010043 absolute risk 15a decision undergo surgery patients newly diagnosed lung cancer independently associated perceptions communication prognosis older age multiple comorbidities black race interventions optimize surgery consider factors