Dolly C Penn1, Karyn B Stitzenberg2, Ewan K Cobran2, Paul A Godley2. 1. University of North Carolina School of Medicine; and University of North Carolina, Lineberger Comprehensive Cancer Center, Chapel, Hill, NC dopenn@unch.unc.edu. 2. University of North Carolina School of Medicine; and University of North Carolina, Lineberger Comprehensive Cancer Center, Chapel, Hill, NC.
Abstract
PURPOSE: The Community Clinical Oncology Program (CCOP) and Minority-Based Community Clinical Oncology Program (MBCCOP) are provider-based research networks (PBRN) that improve minority enrollment in cancer-focused clinical trials. We hypothesized that affiliation with a PBRN may also mitigate racial differences in hospice enrollment for patients with lung cancer. METHODS: We used the SEER-Medicare data, linked to the National Cancer Institute's CCOP program data, to identify all patients (≥ age 65 years) with lung cancer, diagnosed from 2001 to 2007. We defined clinical treatment settings as CCOP, MBCCOP, academic, or community-affiliated and used multivariable logistic regression analysis to determine factors associated with hospice enrollment. RESULTS: Forty-one thousand eight hundred eighty-five (55.1%) patients with lung cancer enrolled in hospice before death. Approximately 55% of CCOP, 57% of MBCCOP, 57% of academic, and 52% of community patients enrolled. Patients who were more likely to enroll were female (odds ratio [OR], 1.36; 95% CI, 1.31 to 1.40); ≥ age 79 years (OR, 1.11; 95%CI, 1.06 to 1.16); white; lived in more educated areas; had minimal comorbidities; and had distant disease. Asian and black patients in academic (41.1% and 50.4%, respectively) and community practices (35.2% and 43.4%, respectively) were less likely to enroll in hospice compared with white patients (academic, 58.8%; community, 53.1%). However, hospice enrollment was equivalent for black and white patients in MBCCOP (59.5% v 57.2%) and CCOP (52.2% v 56.3%) practices. CONCLUSION: Minority patients with lung cancer receiving treatment in cancer-focused PBRN- affiliated practices have greater hospice enrollment than those treated in academic and community practices.
PURPOSE: The Community Clinical Oncology Program (CCOP) and Minority-Based Community Clinical Oncology Program (MBCCOP) are provider-based research networks (PBRN) that improve minority enrollment in cancer-focused clinical trials. We hypothesized that affiliation with a PBRN may also mitigate racial differences in hospice enrollment for patients with lung cancer. METHODS: We used the SEER-Medicare data, linked to the National Cancer Institute's CCOP program data, to identify all patients (≥ age 65 years) with lung cancer, diagnosed from 2001 to 2007. We defined clinical treatment settings as CCOP, MBCCOP, academic, or community-affiliated and used multivariable logistic regression analysis to determine factors associated with hospice enrollment. RESULTS: Forty-one thousand eight hundred eighty-five (55.1%) patients with lung cancer enrolled in hospice before death. Approximately 55% of CCOP, 57% of MBCCOP, 57% of academic, and 52% of community patients enrolled. Patients who were more likely to enroll were female (odds ratio [OR], 1.36; 95% CI, 1.31 to 1.40); ≥ age 79 years (OR, 1.11; 95%CI, 1.06 to 1.16); white; lived in more educated areas; had minimal comorbidities; and had distant disease. Asian and black patients in academic (41.1% and 50.4%, respectively) and community practices (35.2% and 43.4%, respectively) were less likely to enroll in hospice compared with white patients (academic, 58.8%; community, 53.1%). However, hospice enrollment was equivalent for black and white patients in MBCCOP (59.5% v 57.2%) and CCOP (52.2% v 56.3%) practices. CONCLUSION: Minority patients with lung cancer receiving treatment in cancer-focused PBRN- affiliated practices have greater hospice enrollment than those treated in academic and community practices.
Authors: David E Cowall; Bennett W Yu; Sandra L Heineken; Elizabeth N Lewis; Vishal Chaudhry; Joan M Daugherty Journal: J Oncol Pract Date: 2012-05-22 Impact factor: 3.840
Authors: Lori M Minasian; William R Carpenter; Bryan J Weiner; Darrell E Anderson; Worta McCaskill-Stevens; Stefanie Nelson; Cynthia Whitman; Joseph Kelaghan; Ann M O'Mara; Arnold D Kaluzny Journal: Cancer Date: 2010-10-01 Impact factor: 6.860
Authors: William R Carpenter; Anne-Marie Meyer; Yang Wu; Bahjat Qaqish; Hanna K Sanoff; Richard M Goldberg; Bryan J Weiner Journal: Med Care Date: 2012-08 Impact factor: 2.983
Authors: Sirisha Jonnalagadda; Jenny J Lin; Judith E Nelson; Charles A Powell; John Salazar-Schicchi; Andrew R Berman; Steven M Keller; Cardinale B Smith; Linda Lurslurchachai; Ethan A Halm; Howard Leventhal; Juan P Wisnivesky Journal: Chest Date: 2012-11 Impact factor: 9.410
Authors: Frank Vicini; Joyce Nancarrow-Tull; Chirag Shah; Gary Chmielewski; Monty Fakhouri; Stacey A Sitarek; Claire T Feczko; Carol Brzozowski; David L Felten Journal: Cancer Date: 2011-03-31 Impact factor: 6.860
Authors: Jennifer W Mack; Angel Cronin; Nancy L Keating; Nathan Taback; Haiden A Huskamp; Jennifer L Malin; Craig C Earle; Jane C Weeks Journal: J Clin Oncol Date: 2012-11-13 Impact factor: 44.544
Authors: William C Livingood; Angela H Peden; Gulzar H Shah; Nandi A Marshall; Ketty M Gonzalez; Russell B Toal; Dayna S Alexander; Alesha R Wright; Lynn D Woodhouse Journal: BMC Health Serv Res Date: 2015-07-31 Impact factor: 2.655