Published April 23 online in CANCER, a peer-reviewed journal of the American Cancer Society, the study suggests that, as with several other types of cancer, certain yet-to-be-defined genetic and/or environmental factors put Hispanic patients at a survival advantage.
Most studies that look at ethnic and racial disparities in lung cancer compare black patients with whites. To evaluate how survival of Hispanic patients compares with other ethnicities after a lung cancer diagnosis, the Sylvester team, led by Brian Lally, M.D., assistant professor of radiation oncology, and Ali Saeed, an M.D./Ph.D. candidate, analyzed patient information from the Survival, Epidemiology, and End Results (SEER) Database, which compiles incidence and survival data from population-based cancer registries in the United States.
The investigators identified 172,398 adult patients who were diagnosed with any stage of non-small cell lung cancer (the most common form of lung cancer) between 1988 and 2007 for the study, “The influence of Hispanic ethnicity on non-small cell lung cancer histology and patient survival: An analysis of the Survival, Epidemiology, and End Results (SEER) Database.”
Compared with white patients, Hispanic patients had a 15 percent lower risk of dying during the years of the study, whether they were born in the United States or not. “This is important because it shows that our findings are indicative of the Hispanic population in general and not specific to specific groups of Hispanics,” said Lally. Black patients were slightly more likely to die than whites.
“Our findings will motivate researchers and physicians to understand why Hispanics have more favorable outcomes and may shed light on potential environmental factors and/or genetic factors that can explain our observations,” said Saeed.
The researchers also found that Hispanics were more likely to develop a lung cancer type called bronchioalveolar carcinoma, which is not as serious or life-threatening as other types. Saeed said that could be due to genetic predispositions and/or lower smoking rates. Smokers are at increased risk for developing tumor types associated with a poor prognosis.
Saeed noted that the results fit into a phenomenon known as the “Hispanic paradox,” in which Hispanics diagnosed with certain diseases tend to have more favorable outcomes despite socioeconomic factors (such as decreased access to health care and higher poverty rates) that would predict otherwise. This paradox is seen in breast cancer, prostate cancer, cardiovascular disease, and now non-small cell lung cancer.
Also part of the study team were Rebecca Toonkel, M.D., pulmonary fellow; Marilyn K. Glassberg, M.D., associate professor of medicine in the Division of Pulmonary, Critical Care and Sleep Medicine; Dao Nguyen, M.D., professor and B. and Donald Carlin Chair in Thoracic Surgical Oncology; Jennifer Hu, Ph.D., professor of epidemiology and public health and associate director for cancer prevention and control at Sylvester; and David J. Robbins, Ph.D., associate professor of surgery.