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Original research
Extensive stage small cell lung cancer (ES-SCLC) and palliative care disparities: a national cancer database study
  1. Karishma Khullar1,
  2. Jesse J Plascak2,
  3. Muhammad Hamza Habib3,
  4. Samantha Nagengast3 and
  5. Rahul R Parikh1
  1. 1Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
  2. 2Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA
  3. 3Deparment of Medicine, Section of Hematology and Oncology Palliative Medicine, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
  1. Correspondence to Dr Rahul R Parikh, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA; parikhrr{at}cinj.rutgers.edu

Abstract

Objectives Literature on disparities in palliative care receipt among extensive stage small cell lung cancer (ES-SCLC) patients is scarce. The purpose of this study was to examine disparities in palliative care receipt among ES-SCLC patients.

Methods Patients aged 40 years or older diagnosed with ES-SCLC between 2004 and 2015 in the National Cancer DataBase (NCDB) were eligible. Two palliative care variables were created: (1) no receipt of any palliative care and (2) no receipt of pain management-palliative care. The latter variable indicated pain management receipt among those who received any palliative care. Log binomial regression models were constructed to calculate risk ratios by covariates. Unadjusted and mutually adjusted models were created for both variables.

Results Among 83 175 patients, the risk of no palliative care receipt was higher among Blacks compared with Whites in unadjusted and adjusted models (both model HRs 1.02; 95% CIs 1.00 to 1.03, p<0.05). Patients older than 59 years were at a higher risk of not receiving palliative care than younger patients (HR 1.02; 95% CI 1.01 to 1.03 for 59–66, HR 1.04; 95% CI 1.03 to 1.05 for 66–74, HR 1.06; 95% CI 1.05 to 1.08 for >74). Among 19 931 patients, the risk of no pain management-palliative care was higher among black patients on unadjusted analysis (HR 1.02; 95% CI 1.00 to 1.03, p<0.05). Patients between 66 and 74 years were at a higher risk of not receiving pain management-palliative care than patients younger than 59 years (HR 1.02; 95% CI 1.00 to 1.03, p<0.05).

Conclusions Significant disparities exist in palliative care receipt among ES-SCLC patients.

  • Lung

Data availability statement

Data are available upon request.

https://doi.org/10.1136/spcare-2022-004038

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    Data availability statement

    Data are available upon request.

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    Footnotes

    • Contributors KK and RRP were involved in the design and conception of the study, data interpretation and writing and revising of the manuscript. JJP conducted the data management, analysis and statistical procedures. MHH and SN participated in data interpretation and revising the paper. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. RRP accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.