Race, Ethnicity, and Lung Cancer: Enhancing Care for Diverse Communities

Lung cancer ranks as the second most prevalent form of cancer in the United States and stands as the leading cause of cancer-related fatalities. According to the American Cancer Society, approximately 228,820 new cases of lung cancer are expected this year, with nearly 135,720 deaths attributed to the disease.

“Lung cancer impacts individuals across all racial and ethnic backgrounds in the U.S., yet certain vulnerable populations bear a heavier burden,” explains Jeanne Regnante, Chief Health Equity and Diversity Officer at LUNGevity Foundation. “Significant disparities exist among racial and ethnic minority groups, including older adults, rural residents, individuals with disabilities, low-income families, LGBTQ+ individuals, veterans, and immigrant communities,” she added. The prevalence of lung cancer is notably higher among Black Americans, who face an increased risk compared to other racial and ethnic groups.

Black Americans experience higher lung cancer incidence rates and lower survival rates compared to their counterparts from other racial and ethnic groups. “African American men are 37% more likely to receive a lung cancer diagnosis than white men,” Regnante noted. Moreover, regardless of gender, Black Americans often encounter delays in diagnosis and treatment, which complicates effective care.

Statistics indicate that Black individuals diagnosed with lung cancer are more likely to be identified at advanced stages of the disease, which significantly hampers treatment options. The American Cancer Society reported a 5-year relative survival rate of just 16% for lung cancer in Black individuals from 2008 to 2014, compared to 19% for non-Hispanic whites.

Regnante attributes some of the disparities in lung cancer outcomes to inequities in healthcare access, which encompass:

• Cancer screening
• Diagnostic testing
• Therapeutic interventions

“The lower screening rates among African Americans likely contribute to the higher mortality rate,” she asserts. “They also frequently lack access to comprehensive biomarker testing, which could facilitate eligibility for novel targeted therapies that have proven to prolong life.” A 2016 study revealed that Black patients are 66% less likely to receive timely and appropriate lung cancer treatment compared to white patients.

Additionally, Black Americans are less likely to undergo surgical interventions for early-stage lung cancer and receive comprehensive treatment options such as chemotherapy and radiation for advanced stages. Contributing factors include higher rates of being uninsured and economic inequalities that result in limited access to care in rural or economically disadvantaged areas. Furthermore, bias and systemic racism within the healthcare system can hinder timely access to high-quality care.

“Extensive research confirms that numerous patient groups receive subpar care due, in part, to the longstanding biases held by healthcare providers,” Regnante stated. “It is crucial to understand that race is not the risk factor; rather, structural racism is the root cause of these disparities.”

Addressing the disparities in lung cancer care necessitates systemic change. Regnante emphasizes the imperative for healthcare providers, educators, and advocates to acknowledge and combat their biases. They must engage with cancer patients to understand their unique needs and preferences.

“We must establish trust within these communities by actively listening and asking what they need and expect,” Regnante suggested. Collaborating with community leaders and organizations is vital for understanding and mitigating the challenges faced by these vulnerable populations.

“Community engagement is integral to fostering trust, involvement, and access to care,” she noted. “Investing in and seeking the guidance of trusted community leaders is essential to addressing disparities, as they play a critical role in the healthcare landscape.”

Broad societal changes are necessary to ensure diverse populations have access to:

• Safe living environments
• Nourishing food options
• Quality healthcare services

For individuals at risk of lung cancer or those currently diagnosed, self-advocacy is key. Taking an active role in healthcare decisions can significantly improve access to necessary care. Here are some actionable steps:

• Inquire about appropriate lung cancer screening timelines with your healthcare provider.
• If you are a smoker, discuss cessation resources with your provider.
• Communicate any health concerns or symptoms, such as a prolonged cough or breathlessness, to your doctor.
• Ask about testing for potential symptoms of lung cancer, including the associated benefits, risks, and costs.
• Consult your provider regarding various treatment options if diagnosed, exploring all available therapies.
• Alert your provider to any financial barriers impacting your treatment access and seek assistance if needed.
• Request clarification or additional resources if you find your healthcare information unclear.

It's important to seek second opinions if you feel your concerns are dismissed or if discrimination occurs within your healthcare experience.

As advancements in lung cancer treatments continue, patients now have improved chances of living longer and better quality lives. However, further efforts are vital to ensure equitable access to diagnosis and treatment for all Americans.

“This complex issue necessitates collaboration among healthcare stakeholders to effectively address the needs of diverse communities and provide them with trusted resources and timely access to care,” Regnante concluded.