Access to Cancer Specialist Care and Treatment in Patients With Advanced Stage Lung Cancer

Apar Kishor P Ganti, Fred R. Hirsch, Murry W. Wynes, Arliene Ravelo, Suresh S. Ramalingam, Raluca Ionescu-Ittu, Irina Pivneva, Hossein Borghaei

Research output: Contribution to journalArticle

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Abstract

MarketScan and Surveillance, Epidemiology, and End Results–Medicare databases were analyzed separately to evaluate the access to cancer specialists and treatment of patients with advanced stage lung cancer. Between 4% and 12% of the patients were never seen by a cancer specialist, and between 6% and 10% did not receive cancer-directed therapy. Patients seen by a cancer specialist were more likely to receive cancer-directed therapy. Background Access to specialty care is critical for patients with advanced stage lung cancer. This study assessed access to cancer specialists and cancer treatment in a broad population of patients with advanced stage lung cancer. Materials and Methods Two study samples were extracted from 2 claims databases and analyzed independently: patients aged ≥ 18 years with de novo diagnosis of metastatic lung cancer in the MarketScan database between 2008 and 2014 (commercially insured adult patients; n = 22,268); and patients aged ≥ 65 years in the Surveillance, Epidemiology, and End Results–Medicare database with a diagnosis of advanced non–small-cell lung cancer between 2007 and 2011 (Medicare-insured elderly patients; n = 9651). The study period spanned from 6 weeks before the first lung biopsy tied to the initial lung cancer diagnosis until the end of continuous health insurance enrollment, or data availability, or death. Results Among the commercially insured adults (MarketScan), most patients were seen by a cancer specialist within a month of first lung biopsy (80%), 12% were never seen by a cancer specialist, and 6% did not receive cancer-directed therapy. Among the Medicare-insured elderly patients (SEER–Medicare), the proportions were 79%, 4%, and 10%, respectively. Patients seen by a cancer specialist were more likely to receive cancer-directed therapy (95% vs. 92%, P <.001 and 92% vs. 38%, P <.001, respectively). Conclusion Between 4% and 12% of patients with advanced stage lung cancer do not have appropriate access to cancer specialist, which appears to negatively affect access to optimal and timely treatment.

Original languageEnglish (US)
Pages (from-to)640-650.e2
JournalClinical Lung Cancer
Volume18
Issue number6
DOIs
StatePublished - Nov 2017

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Lung Neoplasms
Neoplasms
Therapeutics
Databases
Medicare
Epidemiology
Biopsy
Lung
Critical Care
Health Insurance
Non-Small Cell Lung Carcinoma

Keywords

  • Access to care
  • Cancer-directed therapy
  • Metastatic lung cancer
  • Non–small-cell lung cancer
  • Referral

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

Ganti, A. K. P., Hirsch, F. R., Wynes, M. W., Ravelo, A., Ramalingam, S. S., Ionescu-Ittu, R., ... Borghaei, H. (2017). Access to Cancer Specialist Care and Treatment in Patients With Advanced Stage Lung Cancer. Clinical Lung Cancer, 18(6), 640-650.e2. https://doi.org/10.1016/j.cllc.2017.04.010

Access to Cancer Specialist Care and Treatment in Patients With Advanced Stage Lung Cancer. / Ganti, Apar Kishor P; Hirsch, Fred R.; Wynes, Murry W.; Ravelo, Arliene; Ramalingam, Suresh S.; Ionescu-Ittu, Raluca; Pivneva, Irina; Borghaei, Hossein.

In: Clinical Lung Cancer, Vol. 18, No. 6, 11.2017, p. 640-650.e2.

Research output: Contribution to journalArticle

Ganti, AKP, Hirsch, FR, Wynes, MW, Ravelo, A, Ramalingam, SS, Ionescu-Ittu, R, Pivneva, I & Borghaei, H 2017, 'Access to Cancer Specialist Care and Treatment in Patients With Advanced Stage Lung Cancer', Clinical Lung Cancer, vol. 18, no. 6, pp. 640-650.e2. https://doi.org/10.1016/j.cllc.2017.04.010
Ganti, Apar Kishor P ; Hirsch, Fred R. ; Wynes, Murry W. ; Ravelo, Arliene ; Ramalingam, Suresh S. ; Ionescu-Ittu, Raluca ; Pivneva, Irina ; Borghaei, Hossein. / Access to Cancer Specialist Care and Treatment in Patients With Advanced Stage Lung Cancer. In: Clinical Lung Cancer. 2017 ; Vol. 18, No. 6. pp. 640-650.e2.
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abstract = "MarketScan and Surveillance, Epidemiology, and End Results–Medicare databases were analyzed separately to evaluate the access to cancer specialists and treatment of patients with advanced stage lung cancer. Between 4{\%} and 12{\%} of the patients were never seen by a cancer specialist, and between 6{\%} and 10{\%} did not receive cancer-directed therapy. Patients seen by a cancer specialist were more likely to receive cancer-directed therapy. Background Access to specialty care is critical for patients with advanced stage lung cancer. This study assessed access to cancer specialists and cancer treatment in a broad population of patients with advanced stage lung cancer. Materials and Methods Two study samples were extracted from 2 claims databases and analyzed independently: patients aged ≥ 18 years with de novo diagnosis of metastatic lung cancer in the MarketScan database between 2008 and 2014 (commercially insured adult patients; n = 22,268); and patients aged ≥ 65 years in the Surveillance, Epidemiology, and End Results–Medicare database with a diagnosis of advanced non–small-cell lung cancer between 2007 and 2011 (Medicare-insured elderly patients; n = 9651). The study period spanned from 6 weeks before the first lung biopsy tied to the initial lung cancer diagnosis until the end of continuous health insurance enrollment, or data availability, or death. Results Among the commercially insured adults (MarketScan), most patients were seen by a cancer specialist within a month of first lung biopsy (80{\%}), 12{\%} were never seen by a cancer specialist, and 6{\%} did not receive cancer-directed therapy. Among the Medicare-insured elderly patients (SEER–Medicare), the proportions were 79{\%}, 4{\%}, and 10{\%}, respectively. Patients seen by a cancer specialist were more likely to receive cancer-directed therapy (95{\%} vs. 92{\%}, P <.001 and 92{\%} vs. 38{\%}, P <.001, respectively). Conclusion Between 4{\%} and 12{\%} of patients with advanced stage lung cancer do not have appropriate access to cancer specialist, which appears to negatively affect access to optimal and timely treatment.",
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AU - Ramalingam, Suresh S.

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N2 - MarketScan and Surveillance, Epidemiology, and End Results–Medicare databases were analyzed separately to evaluate the access to cancer specialists and treatment of patients with advanced stage lung cancer. Between 4% and 12% of the patients were never seen by a cancer specialist, and between 6% and 10% did not receive cancer-directed therapy. Patients seen by a cancer specialist were more likely to receive cancer-directed therapy. Background Access to specialty care is critical for patients with advanced stage lung cancer. This study assessed access to cancer specialists and cancer treatment in a broad population of patients with advanced stage lung cancer. Materials and Methods Two study samples were extracted from 2 claims databases and analyzed independently: patients aged ≥ 18 years with de novo diagnosis of metastatic lung cancer in the MarketScan database between 2008 and 2014 (commercially insured adult patients; n = 22,268); and patients aged ≥ 65 years in the Surveillance, Epidemiology, and End Results–Medicare database with a diagnosis of advanced non–small-cell lung cancer between 2007 and 2011 (Medicare-insured elderly patients; n = 9651). The study period spanned from 6 weeks before the first lung biopsy tied to the initial lung cancer diagnosis until the end of continuous health insurance enrollment, or data availability, or death. Results Among the commercially insured adults (MarketScan), most patients were seen by a cancer specialist within a month of first lung biopsy (80%), 12% were never seen by a cancer specialist, and 6% did not receive cancer-directed therapy. Among the Medicare-insured elderly patients (SEER–Medicare), the proportions were 79%, 4%, and 10%, respectively. Patients seen by a cancer specialist were more likely to receive cancer-directed therapy (95% vs. 92%, P <.001 and 92% vs. 38%, P <.001, respectively). Conclusion Between 4% and 12% of patients with advanced stage lung cancer do not have appropriate access to cancer specialist, which appears to negatively affect access to optimal and timely treatment.

AB - MarketScan and Surveillance, Epidemiology, and End Results–Medicare databases were analyzed separately to evaluate the access to cancer specialists and treatment of patients with advanced stage lung cancer. Between 4% and 12% of the patients were never seen by a cancer specialist, and between 6% and 10% did not receive cancer-directed therapy. Patients seen by a cancer specialist were more likely to receive cancer-directed therapy. Background Access to specialty care is critical for patients with advanced stage lung cancer. This study assessed access to cancer specialists and cancer treatment in a broad population of patients with advanced stage lung cancer. Materials and Methods Two study samples were extracted from 2 claims databases and analyzed independently: patients aged ≥ 18 years with de novo diagnosis of metastatic lung cancer in the MarketScan database between 2008 and 2014 (commercially insured adult patients; n = 22,268); and patients aged ≥ 65 years in the Surveillance, Epidemiology, and End Results–Medicare database with a diagnosis of advanced non–small-cell lung cancer between 2007 and 2011 (Medicare-insured elderly patients; n = 9651). The study period spanned from 6 weeks before the first lung biopsy tied to the initial lung cancer diagnosis until the end of continuous health insurance enrollment, or data availability, or death. Results Among the commercially insured adults (MarketScan), most patients were seen by a cancer specialist within a month of first lung biopsy (80%), 12% were never seen by a cancer specialist, and 6% did not receive cancer-directed therapy. Among the Medicare-insured elderly patients (SEER–Medicare), the proportions were 79%, 4%, and 10%, respectively. Patients seen by a cancer specialist were more likely to receive cancer-directed therapy (95% vs. 92%, P <.001 and 92% vs. 38%, P <.001, respectively). Conclusion Between 4% and 12% of patients with advanced stage lung cancer do not have appropriate access to cancer specialist, which appears to negatively affect access to optimal and timely treatment.

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