Does Where Patients Live Affect Their Chances of Surviving Lung Cancer?

By: Joshua D. Madera, MD
Posted: Thursday, October 10, 2024

The persistent disparities present in socially disadvantaged patients with non–small cell lung cancer (NSCLC) have motivated researchers to identify the impact of socioeconomic status on overall survival and mortality, according to a study published in BMC Cancer. Patients with increased neighborhood-level deprivation may demonstrate increased liquid biopsy DNA methylation, higher rates of mortality, and decreased overall survival, explained Alicia Hulbert, MD, of the University of Illinois College of Medicine in Chicago, and colleagues. According to the study authors, neighborhood-level deprivation often encompasses geospatially aggregated indices of employment, occupation, education, housing conditions, income, and wealth; these factors cumulatively may impact a person’s health.

“Changes in health-care policies that consider neighborhood-level indices of socioeconomic deprivation may enable a more equitable increase in lung cancer survival,” suggested Dr. Hulbert and her colleagues.

From 2008 to 2020, a total of 173 patients with NSCLC were recruited for the study. Patients were stratified based on their neighborhood deprivation index as low deprivation (n = 85) or high deprivation (n = 88). Demographic information was gathered from all patients. Liquid-based biopsy samples were collected from all patients to measure the extent of DNA methylation.

The study findings revealed a significantly increased neighborhood deprivation index among Black patients compared with White patients. In addition, various genes were found to be significantly associated with DNA methylation. These genes included CDO1, HOXA7, HOXA9, SOX17, TAC1, and ZFP42. Furthermore, the neighborhood deprivation index was significantly associated with the DNA methylation of HOXA7. Overall survival was reduced in high-deprivation patients compared with low-deprivation patients. Moreover, after adjustments were made for patient demographic information, an association was identified between high-deprivation patients and increased mortality (hazard ratio = 1.81).

Disclosure: The study authors reported no conflicts of interest.

BMC Cancer

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