Retrospective cohort study of early-stage lung cancer treatment disparities by race among Medicare beneficiaries

Studies in the 1990s and early 2000s demonstrated racial disparities in lung cancer care for Medicare beneficiaries, with a 13% to 15% difference in receipt of curative therapies between Black and White patients. A retrospective cohort study using the SEER-Medicare database examined temporal trends in racial disparities in the receipt of curative treatmen for early-stage NSCLC among Medicare beneficiaries from 2005-2007, 2011-2013, and 2017-2019. The study included 28,287 non-Hispanic Black (7.5%) and non-Hispanic White (92.5%) patients aged 66 to 85 years who received a diagnosis of stage I or stage II NSCLC. Adjusted probabilities of receiving curative treatment were significantly lower for Black compared with White patients in each of the three time periods. Disparities were associated primarily with differences in surgical treatment. SBRT use increased sharply, and disparities in its used emerged only during 2011 to 2013. The authors conclude that this study suggests that disparities between Black and White patients with early-stage NSCLC persist for Medicare beneficiaries.