Hispanics/Latinos in the Bronx Have Improved Survival in Non-Small Cell Lung Cancer Compared with Non-Hispanic Whites

Madelyn Klugman, Xiaonan Xue, Mindy Ginsberg, Haiying Cheng, Thomas Rohan, H. Dean Hosgood

Research output: Contribution to journalArticle

Abstract

Background: Hispanics/Latinos are a growing yet understudied population in the United States (US). Despite lower socioeconomic status, Hispanics/Latinos tend to have similar or better health outcomes than Non-Hispanic Whites (NHWs). This phenomenon has not been conclusively studied for lung cancer. Methods: Using a cohort of patients at Montefiore Medical Center (MMC) in the Bronx, NY, we examined factors related to lung cancer survival by race/ethnicity with an emphasis on Hispanics/Latinos. Subjects were diagnosed with non-small cell lung cancer (NSCLC) between 2004 and 2017. Demographic and clinical data were obtained from MMC’s clinical systems and tumor-related information from MMC/Einstein’s Cancer Registry. Survival was assessed using Cox proportional hazards modeling adjusted for clinical and sociodemographic factors including smoking. Factors related to survival within each major racial/ethnic group were examined. Results: Hispanics/Latinos experienced decreased risk of death relative to NHWs [hazard ratio (HR) = 0.70, 95% confidence interval (95%CI) 0.57–0.86] overall and by sex (males: HR = 0.78, 95%CI 0.59–1.03, females: HR = 0.61, 95%CI 0.44–0.86). Decreased risk among Hispanics/Latinos relative to NHWs was evident in never-smokers (HR = 0.55, 95%CI 0.29–1.01), ever-smokers (HR = 0.72, 95%CI 0.57–0.90), younger subjects (HR = 0.73, 95%CI 0.54–0.99), and older subjects (HR = 0.72, 95%CI 0.53–0.97). Surgery was associated with improved survival in Hispanics/Latinos (HR = 0.60, 95%CI 0.43–0.85), and smoking with worse survival (HR = 1.56, 95%CI 1.02–2.39). Survival did not differ between Non-Hispanic Blacks and NHWs. Conclusions: In a poor urban community, Hispanics/Latinos experience improved survival from NSCLC compared to NHWs, which is not entirely explained by smoking. Future research should investigate the drivers of this benefit and differences in survival by Hispanic/Latino origin.

Original languageEnglish (US)
JournalJournal of Racial and Ethnic Health Disparities
DOIs
StateAccepted/In press - Jan 1 2019

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Hispanic Americans
Non-Small Cell Lung Carcinoma
cancer
confidence
Survival
Confidence Intervals
smoking
Smoking
sociodemographic factors
Lung Neoplasms
surgery
social status
ethnic group
ethnicity
driver
death
Ethnic Groups
Social Class
health
Registries

Keywords

  • Epidemiology
  • Ethnicity
  • Lung
  • Mortality
  • Race

ASJC Scopus subject areas

  • Health(social science)
  • Anthropology
  • Sociology and Political Science
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

@article{16dd88aa795c43158aae46ed145455c7,
title = "Hispanics/Latinos in the Bronx Have Improved Survival in Non-Small Cell Lung Cancer Compared with Non-Hispanic Whites",
abstract = "Background: Hispanics/Latinos are a growing yet understudied population in the United States (US). Despite lower socioeconomic status, Hispanics/Latinos tend to have similar or better health outcomes than Non-Hispanic Whites (NHWs). This phenomenon has not been conclusively studied for lung cancer. Methods: Using a cohort of patients at Montefiore Medical Center (MMC) in the Bronx, NY, we examined factors related to lung cancer survival by race/ethnicity with an emphasis on Hispanics/Latinos. Subjects were diagnosed with non-small cell lung cancer (NSCLC) between 2004 and 2017. Demographic and clinical data were obtained from MMC’s clinical systems and tumor-related information from MMC/Einstein’s Cancer Registry. Survival was assessed using Cox proportional hazards modeling adjusted for clinical and sociodemographic factors including smoking. Factors related to survival within each major racial/ethnic group were examined. Results: Hispanics/Latinos experienced decreased risk of death relative to NHWs [hazard ratio (HR) = 0.70, 95{\%} confidence interval (95{\%}CI) 0.57–0.86] overall and by sex (males: HR = 0.78, 95{\%}CI 0.59–1.03, females: HR = 0.61, 95{\%}CI 0.44–0.86). Decreased risk among Hispanics/Latinos relative to NHWs was evident in never-smokers (HR = 0.55, 95{\%}CI 0.29–1.01), ever-smokers (HR = 0.72, 95{\%}CI 0.57–0.90), younger subjects (HR = 0.73, 95{\%}CI 0.54–0.99), and older subjects (HR = 0.72, 95{\%}CI 0.53–0.97). Surgery was associated with improved survival in Hispanics/Latinos (HR = 0.60, 95{\%}CI 0.43–0.85), and smoking with worse survival (HR = 1.56, 95{\%}CI 1.02–2.39). Survival did not differ between Non-Hispanic Blacks and NHWs. Conclusions: In a poor urban community, Hispanics/Latinos experience improved survival from NSCLC compared to NHWs, which is not entirely explained by smoking. Future research should investigate the drivers of this benefit and differences in survival by Hispanic/Latino origin.",
keywords = "Epidemiology, Ethnicity, Lung, Mortality, Race",
author = "Madelyn Klugman and Xiaonan Xue and Mindy Ginsberg and Haiying Cheng and Thomas Rohan and Hosgood, {H. Dean}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s40615-019-00660-2",
language = "English (US)",
journal = "Journal of racial and ethnic health disparities",
issn = "2197-3792",
publisher = "Springer Nature",

}

TY - JOUR

T1 - Hispanics/Latinos in the Bronx Have Improved Survival in Non-Small Cell Lung Cancer Compared with Non-Hispanic Whites

AU - Klugman, Madelyn

AU - Xue, Xiaonan

AU - Ginsberg, Mindy

AU - Cheng, Haiying

AU - Rohan, Thomas

AU - Hosgood, H. Dean

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Hispanics/Latinos are a growing yet understudied population in the United States (US). Despite lower socioeconomic status, Hispanics/Latinos tend to have similar or better health outcomes than Non-Hispanic Whites (NHWs). This phenomenon has not been conclusively studied for lung cancer. Methods: Using a cohort of patients at Montefiore Medical Center (MMC) in the Bronx, NY, we examined factors related to lung cancer survival by race/ethnicity with an emphasis on Hispanics/Latinos. Subjects were diagnosed with non-small cell lung cancer (NSCLC) between 2004 and 2017. Demographic and clinical data were obtained from MMC’s clinical systems and tumor-related information from MMC/Einstein’s Cancer Registry. Survival was assessed using Cox proportional hazards modeling adjusted for clinical and sociodemographic factors including smoking. Factors related to survival within each major racial/ethnic group were examined. Results: Hispanics/Latinos experienced decreased risk of death relative to NHWs [hazard ratio (HR) = 0.70, 95% confidence interval (95%CI) 0.57–0.86] overall and by sex (males: HR = 0.78, 95%CI 0.59–1.03, females: HR = 0.61, 95%CI 0.44–0.86). Decreased risk among Hispanics/Latinos relative to NHWs was evident in never-smokers (HR = 0.55, 95%CI 0.29–1.01), ever-smokers (HR = 0.72, 95%CI 0.57–0.90), younger subjects (HR = 0.73, 95%CI 0.54–0.99), and older subjects (HR = 0.72, 95%CI 0.53–0.97). Surgery was associated with improved survival in Hispanics/Latinos (HR = 0.60, 95%CI 0.43–0.85), and smoking with worse survival (HR = 1.56, 95%CI 1.02–2.39). Survival did not differ between Non-Hispanic Blacks and NHWs. Conclusions: In a poor urban community, Hispanics/Latinos experience improved survival from NSCLC compared to NHWs, which is not entirely explained by smoking. Future research should investigate the drivers of this benefit and differences in survival by Hispanic/Latino origin.

AB - Background: Hispanics/Latinos are a growing yet understudied population in the United States (US). Despite lower socioeconomic status, Hispanics/Latinos tend to have similar or better health outcomes than Non-Hispanic Whites (NHWs). This phenomenon has not been conclusively studied for lung cancer. Methods: Using a cohort of patients at Montefiore Medical Center (MMC) in the Bronx, NY, we examined factors related to lung cancer survival by race/ethnicity with an emphasis on Hispanics/Latinos. Subjects were diagnosed with non-small cell lung cancer (NSCLC) between 2004 and 2017. Demographic and clinical data were obtained from MMC’s clinical systems and tumor-related information from MMC/Einstein’s Cancer Registry. Survival was assessed using Cox proportional hazards modeling adjusted for clinical and sociodemographic factors including smoking. Factors related to survival within each major racial/ethnic group were examined. Results: Hispanics/Latinos experienced decreased risk of death relative to NHWs [hazard ratio (HR) = 0.70, 95% confidence interval (95%CI) 0.57–0.86] overall and by sex (males: HR = 0.78, 95%CI 0.59–1.03, females: HR = 0.61, 95%CI 0.44–0.86). Decreased risk among Hispanics/Latinos relative to NHWs was evident in never-smokers (HR = 0.55, 95%CI 0.29–1.01), ever-smokers (HR = 0.72, 95%CI 0.57–0.90), younger subjects (HR = 0.73, 95%CI 0.54–0.99), and older subjects (HR = 0.72, 95%CI 0.53–0.97). Surgery was associated with improved survival in Hispanics/Latinos (HR = 0.60, 95%CI 0.43–0.85), and smoking with worse survival (HR = 1.56, 95%CI 1.02–2.39). Survival did not differ between Non-Hispanic Blacks and NHWs. Conclusions: In a poor urban community, Hispanics/Latinos experience improved survival from NSCLC compared to NHWs, which is not entirely explained by smoking. Future research should investigate the drivers of this benefit and differences in survival by Hispanic/Latino origin.

KW - Epidemiology

KW - Ethnicity

KW - Lung

KW - Mortality

KW - Race

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U2 - 10.1007/s40615-019-00660-2

DO - 10.1007/s40615-019-00660-2

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JO - Journal of racial and ethnic health disparities

JF - Journal of racial and ethnic health disparities

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