Ethnic Differences in Survival Among Lung Cancer Patients: A Systematic Review

A partir d'une revue systématique de la littérature publiée entre janvier 2000 et juillet 2020 (28 articles), cette étude analyse les disparités ethniques dans la survie globale et la survie spécifique des patients atteints d'un cancer du poumon

Résumé en anglais

Despite a substantially worse risk factor profile, Hispanics in the United States experience lower incidence of many diseases and longer survival than non-Hispanic Whites (NHWs), an epidemiological phenomenon known as the Hispanic Health Paradox (HHP). This systematic review evaluated the published longitudinal literature to address whether this pattern extends to lung cancer survival.Searches of Medline, PubMed, Embase, Web of Science, and the Cochrane Library were conducted for January 1, 2000 to July 18, 2018. Records were restricted to articles written in English, employing a longitudinal design, and reporting a direct survival comparison (overall survival, OS; cancer-specific survival, CSS) between NHW and Hispanic lung cancer patients.A final sample of 29 full-text articles were included, including 28 fully adjusted models of OS and 21 of CSS. Overall, 26 (92.9%) OS models and 20 (95.2%) CSS models documented either no difference (16 OS, 11 CSS) or a Hispanic survival advantage (10 OS, 9 CSS). Both larger studies and those including foreign-born Hispanics were more likely to show a Hispanic survival advantage, while two studies of exclusively non-smokers showed a survival disadvantage. A number of reporting gaps were identified including Hispanic background and sociodemographic characteristics.Hispanics exhibit similar or better survival in the context of lung cancer relative to NHWs despite a considerably worse risk factor profile. These findings support the HHP in the context of lung cancer. Further research is needed to understand the potential mechanisms of the HHP as it relates to lung cancer.