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Diversity in Clinical Trials Reduces Health Disparities

Although lung cancer is the second most common cancer in men and women, it is the leading cause of cancer-related deaths in both genders. The American Cancer Society estimates lung cancer will kill more than 130,000 Americans this year.

Believe it or not, that’s actually good news. “The number of new cases of lung cancer continues to decrease. There’s also a decreased number of deaths due to lung cancer,” said Yewande Odeyemi, M.D., a Rochester, Minnesota, pulmonologist at a Precision Oncology event in Atlanta last month.

She credits the lower incidence of and death rates from lung cancer to folks kicking their smoking habit coupled with earlier detection of the disease. “We are able to detect lung cancer at a very early stage and offer treatment to patients,” she said.

Alas, health disparities still exist. “Black men are more likely to develop and die from lung cancer,” Dr. Odeyemi said.

In fact, black men are 15 percent to 37 percent more likely to develop lung cancer than their white counterparts. The 5-year survival rate for our men is about 15 percent, compared to 12 percent in white men. This is due in part, Dr. Odeyemi said, to several factors:

  • Black men are usually diagnosed with late stage lung cancer.
  • They are less likely to receive the recommended course of treatment.
  • The are more likely to refuse treatment.

To change these statistics, prevention is the key. This starts with smoking prevention and cessation, something at which black folks are excelling. “I’ve been very impressed with the smoking cessation among the black community,” Dr. Odeyemi told the audience in Atlanta. “Unfortunately, a lot of evidence and research shows black men are more reluctant to seek preventive care because of fear of the disease.”

When we can’t prevent a lung cancer diagnosis, early detection is critical. This includes lung cancer screening, which enables doctors to pick up lung cancer at a very early stage and design an individualized treatment plan each patient. Treatment in 2020 may include surgery, radiation, chemotherapy, targeted therapy or immunotherapy.

“In the last decade, there have been so many clinical trials,” Dr. Odeyemi said. “Now we have very good treatment for lung cancer. We are able to target lung cancer in a unique way, including medications to help the immune system fight against this cancer.”

In fact, new medications are being created regularly. “The NIH in the last two decades has increased funding for lung cancer. There are over 1,000 clinical trials available for just lung cancer,” she said.

So it goes without saying that with such dismal survival numbers, it’s likely we have huge health disparities in access to centers that offer these new therapies. “We’ve found that black patients were only 78 percent as likely as their white counterparts to receive treatment,” she said. “Our research also shows black men are so underrepresented in lung cancer clinical trials they constitute less than 4 percent of all patients enrolled in multiple trials.

What can we do to improve disparities? “Increase awareness,” Dr. Odeyemi said. That means:

  • Inform more patients about lung cancer screening.
  • Continue to talk about smoking cessation with our family members. “Second-hand exposure does matter,” she said. “It’s not about you smoking, but those who smoke around you.”
  • Increase awareness about advanced treatment options, including targeted therapy and immunotherapy
  • Increase awareness about clinical trial participation so we can have medications that consider the uniqueness of black men. 

 “The new therapies—immune and targeted—should be approved with the consideration of the uniqueness of black men. Without this consideration,” she said, “health disparities will continue.”

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