The results of a recent study show that the obstacles faced by American patients to receive a validated first-line treatment for lung cancer result in a loss of chance.
Despite decades of clinical research establishing the combination of chemotherapy and chest radiotherapy as a gold standard treatment for the initial management of non-metastatic small cell lung cancer, a large number of American patients do not receive these treatments in a controlled manner. study published in JAMA Oncology.
In this study of more than 70,000 cases, patients who received both chemotherapy and radiotherapy had a median survival of 18 months, while those who received only chemotherapy (20.5%) or only radiotherapy (3.5%), the prognosis is poor with a median survival of only 10.5 or 8.3 months (compared to 3.7 months in the absence of any treatment).
The social obstacle to information and access to care
To improve access to care and address related disparities, researchers have tried to understand the barriers that patients face when treated for lung cancer in the United States.
Multiple socio-economic factors are strongly associated with overall survival. Treatment at a non-university center, lack of health insurance and Medicare / Medicaid coverage are also associated with significantly shorter survival. Apart from reimbursement, these factors are not far removed from those found in France: being less well informed about health resources or being in a less well equipped territory is a pejorative criterion in cancer.
Further research is needed to better define population profiles and specific resource gaps to improve care.