Racial Disparities in Lung Cancer Resection

Major advances have been made in the ability to image and identify lung tumors and metastases, diagnose and stage lung cancer with minimally invasive techniques, and safely resect early-stage lung cancers in medically tenuous patients. However, despite remarkable technological achievements, lung cancer is the leading cause of cancer death in the United States and 5-year survival is poor at 15.8%.¹ In response to this situation in which advanced techniques have not resulted in meaningfully better outcomes, Cykert and colleagues,² in this issue of JAMA, explore fundamentally important questions about current management of lung cancer. The authors begin with the accepted premise that surgical resection is the preferred approach to managing stage I or II non–small cell lung cancer, and hypothesize that fewer blacks than whites will undergo curative-intent resection. Based on their study of 437 patients with biopsy-proven or probable early-stage lung cancer, the investigators confirmed their hypothesis and suggest that cultural differences might be the explanation.