Racial disparities in non–small cell lung cancer survival outcomes: a systematic review and meta-analysis
Bibliographic record
Abstract
Background Previous studies have demonstrated disparities in survival outcomes between Black/African American, Asian, and White patients with non–small cell lung cancer (NSCLC). Some studies have suggested that non-White patients have poorer survival outcomes due to socioeconomic factors, while others have reported different findings. Therefore, we performed a comprehensive review and meta-analysis to evaluate the impact of racial disparity on NSCLC survival outcomes.Method PubMed, Ovid MEDLINE, Embase, and Google Scholar were searched for articles published until September 2024. Eligible studies with aligned research objectives were included. Two reviewers independently extracted data. Methodological quality was assessed using the Newcastle-Ottawa Scale. The meta-analysis adhered to the PRISMA guidelines.Result Fifteen studies with 763,314 patients met the eligibility criteria. Asian and Asian/Pacific Islander (API) patients had significantly better overall survival (OS) compared to White patients (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.79–0.94; P < 0.01 and HR, 0.80; 95% CI, 0.69–0.93; P < 0.01, respectively). In contrast, OS differences were not statistically significant between Black and White (HR, 1.00; 95% CI, 0.94–1.07; P < 0.01) or Hispanic and White patients (HR, 0.93; 95% CI, 0.87–1.00; P = 0.19). Further, the subgroup analyses did not demonstrate any significant difference in OS outcome in any stage when comparing Black to White patients (stage I HR, 1.11; 95% CI, 1.00–1.23; P < 0.01; stage II HR, 1.03; 95% CI, 0.96–1.10; P = 0.26; stage III HR, 1.04; 95% CI, 0.96–1.12; P < 0.01; and stage IV HR, 1.02; 95% CI, 0.97–1.07; P < 0.01).Conclusion Asian and API patients with NSCLC exhibited superior OS outcomes compared to White patients. In contrast, racial disparities in survival outcomes were statistically insignificant for Black and Hispanic patients. Additionally, staging disparities in OS were not observed between Black and White patients with NSCLC.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.008 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".