CHEST Guidelines-Are-We-There-Yet-

Are-We-There-Yet-_chest

Pdf Summary

The editorial by Frank C. Detterbeck examines a study by Balekian et al. into racial and gender disparities in surgical resection rates among participants of the National Lung Screening Trial (NLST) with clinical stage I non-small cell lung cancer (NSCLC). The study found that black men had significantly lower resection rates (61%) than white men (92%), white women (91%), and black women (90%). Despite adjusting for factors such as age, education, marital status, comorbidities, smoking status, tumor characteristics, and healthcare access, the disparities remained, suggesting a more complex interplay of factors.<br /><br />Detterbeck questions why racial disparities appear only among men and whether sex-specific differences are limited to blacks. He points out that confounding factors might not be fully accounted for, and calls into question the assumptions that underlie multivariate regression analysis. The variable resection rates by enrollment centers, and differences in tumor types and detection modes among racial and sex cohorts, indicate potential oversights or partial adjustments in the study's analysis.<br /><br />Detterbeck argues against simplifying complex issues down to race-related biases and instead suggests focusing on understanding the true drivers of resection rate differences. He warns that terms like "race" and "disparities" carry inherent biases and assumptions, complicating objective interpretation. He sees the study as a step forward but emphasizes the need for deeper investigation into what truly determines resection rates, concluding that while progress is being made, understanding remains incomplete, and solutions may lie in more nuanced analyses beyond race and sex markers. The editorial advocates for a shift in perspective to ensure equitable application of advancements in lung cancer treatment.

Keywords

racial disparities

gender disparities

surgical resection rates

National Lung Screening Trial

non-small cell lung cancer

racial biases

multivariate regression analysis

healthcare access

tumor characteristics

equitable treatment