Abstract
1. Participants will self-report the ability to recognize which socioeconomic factors make an individual with small cell lung cancer more likely to receive palliative care.
Small cell lung cancer (SCLC) is an aggressive, often metastatic, form of lung cancer. Due to its aggressive nature, individuals with SCLC may experience a variety of symptoms, which palliative care (PC) can help alleviate.
To identify socioeconomic factors that affect PC utilization in SCLC patients
Using the National Cancer Database (2004–2019), patients with SCLC were identified (N=305,082), and Pearson's chi-squared test with Bonferroni adjustment was used to identify any significant relationships between PC and socioeconomic factors.
The majority of SCLC patients receiving PC are white (90.3%) and most are insured by Medicare (58.7%). From 2004 to 2019, PC usage has risen steadily from 11.5% to 19.3%. While 77.7% of the study population lives in metropolitan areas, only 15.7% receive PC. Among patients who receive PC, 78% live in metropolitan areas, while only 2.8% live in rural areas. Male patients and those under 60 years of age are more likely to receive PC, especially chemotherapy and radiation (p< 0.05). Patients receiving treatment at an academic/research facility (25.4%) and those with a median income under $38,000 (19.3%) are also more likely to receive PC (p< 0.05). Patients are less likely to receive PC when being treated at facilities in Mountain (2.8%), Pacific (5.7%), and West South Central (5.6%) areas (p< 0.05). Individuals with a Spanish/Hispanic origin are less likely to receive PC, while those without a Spanish/Hispanic origin are more likely to receive PC, especially chemotherapy (p< 0.05).
Despite the benefits that PC can provide SCLC patients, certain groups are underutilizing PC. Whether an individual with SCLC receives PC is influenced by facility type and location, insurance, income, sex, age, and the area they reside in, and more research is needed to determine why these differences in PC usage exist.