Abstract
Background
Identifying factors that influence the diagnosis and treatment of lung cancer is an important public health initiative. Various sociodemographic factors, including race and ethnicity, may influence an individual’s risk of developing lung cancer, as well as access to relevant diagnostic and therapeutic procedures.
Methods
Data from the 2006 Canadian long-form census were cross-linked with the Canadian Cancer Registry and hospital data to determine rates of lung cancer diagnosis among visible minorities and non-visible minorities in Canada, and to assess for differences in rates of hospital-based procedures pertaining to a lung cancer diagnosis based on visible-minority status. Individuals were allocated into six visible-minority categories, and separate results were generated nationally and across seven regions. Multivariate logistic regression controlled for relevant confounders.
Results
Rates of lung cancer were significantly lower among visible minorities versus non-visible minorities (329 versus 1108 cases per 100 000). This result is consistent across all visible-minority subgroups. Among those with a diagnosis of lung cancer, procedure rates were higher for all visible minorities nationally (53.4% [95% CI 53.2–53.6]). Multivariable analysis demonstrated higher procedure rates in general for visible minorities with a lung cancer diagnosis compared to non-visible minorities (OR 1.158 95% CI 1.053–1.273).
Interpretation
In Canada, visible minorities experience lower rates of lung cancer diagnosis than non-visible minorities. Among those with a lung cancer diagnosis, we did not identify any negative disparities in rates of relevant diagnostic or therapeutic procedures, based on visible-minority status.
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Data availability
The data used for this project were accessed through the Statistics Canada Research Data centre program. Data are only available at highly secure facilities to researchers who are deemed Statistics Canada employees after a thorough background check. As a result, data are not publicly available. For more information see https://www.statcan.gc.ca/en/microdata/data-centres.
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Appendix A
Appendix A
Canadian classification of health intervention code (CCI) | Description |
|---|---|
Therapeutic intervention codes | |
1.GR.87.^^ | Excision partial, lobe of lung Lingulectomy, Lobectomy partial, Segmentectomy, lobe of lung [with removal of two segments (e.g., partial excision of two different lobes)], Wedge resection |
1.GR.89.^^ | Excision total, lobe of lung Lobectomy complete, lobe of lung (with or without stapler) |
1.GR.91.^^^ | Excision radical, lobe of lung Dissection of brachial plexus, bronchus, ribs (transverse process), intercostal structures and sympathetic nerves along with the lungs Lobectomy (sleeve), lobe of lung with excision of a portion of the bronchus and subsequent reanastomosis [with chest wall resection; removal of adjoining/attached lymph nodes] |
Diagnostic intervention codes | |
2.GM.70.^^ | Inspection, bronchus Bronchoscopy [without biopsy] |
2.GM.71.^^ | Biopsy, bronchus Bronchoscopy with bronchial tissue biopsy Bronchoscopy with brush biopsy; using open approach |
2.GT.70.^^ | Inspection, lung using open approach |
2.GT.71.^^ | Biopsy, lung Bronchoscopy with lung tissue biopsy using endoscopic approach and needle aspiration Bronchoscopy with trans bronchial lung biopsy using VATS; percutaneous (needle) approach; or open approach |
2.GV.70.^^ | Inspection, pleura Pleuroscopy (using open approach or VATS) |
2.GV.71.^^ | Biopsy, pleura Using VATS, percutaneous approach or open approach |
2.GW.70.^^ | Inspection, mediastinum Mediastinoscopy, or using open approach (anterior mediastinotomy) |
2.GW.71.^^ | Biopsy, mediastinum Mediastinoscopy, percutaneous (needle) approach, or open approach (anterior mediastinotomy) |
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McFadgen, H., Lethbridge, L., Dunbar, M. et al. Trends in lung cancer diagnosis and care among visible minorities and non-visible minorities in Canada. Cancer Causes Control 35, 575–582 (2024). https://doi.org/10.1007/s10552-023-01816-6
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DOI: https://doi.org/10.1007/s10552-023-01816-6