Lung Cancer Care Disparities: Are They Truly Inclusive?

Lung Cancer Health Care Delivery, Community Building, and Research: Are They Truly Inclusive?

Lung cancer was first identified as a distinct disease in 1761. Since this discovery, we have come a long way—both in terms of progress towards understanding the heterogeneous biology of the disease and translating this understanding into action by development of new treatments. Indeed, since 2015, the United States Food and Drug Administration (FDA) has approved more than 25 new treatment approaches for lung cancer, including combination therapies and expanded approvals. With this progress has come the need to evaluate how lung cancer care is delivered and more importantly, to ensure that all patients have equitable access to adequate care to benefit from this progress. Defined as “a particular type of health difference that is closely linked with economic, social, or environmental disadvantage and affecting groups of people who have systematically experienced greater social or economic obstacles to health based on their racial or ethnic group, religion, socioeconomic status, gender, age, or mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion,” health disparities in the lung cancer care continuum continue to persist and are well documented. When we look at recent lung cancer statistics in the United States (see Table), it is obvious that understanding health disparities requires us to look beyond a simplistic single construct focus on race and ethnicity. For example, the Table demonstrates that combining poverty data with race/ethnicity highlights the intersectionality of these two constructs to identify our most vulnerable patients with lung cancer.

Despite the advancements in research and treatment for lung cancer, there are still vast disparities across the cancer care continuum, both in the United States and worldwide. There is a wide range of research documenting health disparities across numerous disparate, vulnerable, and underserved populations; however, understanding why these disparities persist, and more importantly, how they can be fixed to equalize and improve patient care in the real-world setting has not been well documented, especially given that these disparities are pronounced at several levels (see Figure – constructed based on the definition of health disparity provided in Healthy People 2020). As our communities become more diverse, it is increasingly important to recognize and address health disparities in all underserved communities.