Study: Lung Cancer Risk is Higher for Individuals Living in Poorer Neighborhoods
A pack-a-day smoker living in a wealthy neighborhood is less likely to develop lung cancer than someone who smokes the same amount but lives in a poorer neighborhood, according to a recently published study led by MetroHealth researchers.
“Our findings are important in that they showed that neighborhood socioeconomic conditions were a strong predictor of lung cancer risk, even after adjusting for individual risk factors,” said Yasir Tarabichi, MD, an assistant professor at the Case Western Reserve University School of Medicine and MetroHealth physician, who led the study.
Dr. Tarabichi is one of seven researchers who conducted the study, “Neighborhood Disadvantage and Lung Cancer Incidence in Ever-Smokers at a Safety-Net Healthcare System: A Retrospective Study,” the results of which were published this month in CHEST.
The authors studied the electronic health records of 41,615 smokers treated at MetroHealth between 1999 and 2018, including 1,149 who developed lung cancer. The patients were a diverse group of men and women over the age of 55 who smoked varying amounts and came from neighborhoods ranging from the disadvantaged to the affluent.
Neighborhood deprivation was strongly associated with lung cancer risk, even after adjusting for other risk factors inclusive of age, race, ethnicity, smoking exposure, lung disease and family history of lung cancer.
“We found that even after controlling for these and other variables, individuals residing in disadvantaged neighborhoods had a significantly higher risk of lung cancer incidence,” the authors wrote. “Our study is the first to demonstrate such a strong association between lung cancer incidence and neighborhood deprivation while also accounting for smoking exposure in the United States.”
According to the authors, more research is needed, but there are numerous factors that could explain why living in a poorer neighborhood may be a significant driver of lung-cancer risk. Possible explanations include more limited dietary options and choices, greater exposure to environmental carcinogens at home and in the work environment, and higher levels of biologic stress seen in at-risk populations.
“The findings of our study change how we think about lung cancer risk, particularly through the lens of lung cancer screening practices,” Dr. Tarabichi said. “To date, candidates for lung cancer screening are selected based on their age and smoking exposure alone. Our data adds to a growing body of evidence that suggests that using only these variables disadvantages certain populations and potentially exacerbates racial and socioeconomic disparities in the detection and treatment of lung cancer.”
The study’s authors are Yosra Adie, Daniel J. Kats, Abdulhakim Tlimat, Adam Perzynski, Jarrod Dalton, Douglas Gunzler and Yasir Tarabichi.
The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it.
The system’s more than 600 doctors, 1,700 nurses and 7,800 employees go to work each day with a mission of service, to their patients and to the community. As Cuyahoga County’s safety-net health system, MetroHealth plays an essential role in the region, caring for anyone and everyone, regardless of an ability to pay.
Founded in 1837, MetroHealth operates four hospitals, four emergency departments and more than 20 health centers and 40 additional sites throughout Cuyahoga County. The system serves more than 300,000 patients, two-thirds of whom are uninsured or covered by Medicare or Medicaid.
MetroHealth is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992, and Ohio’s only adult and pediatric trauma and burn center.
As an academic medical center, MetroHealth is committed to research and to teaching and training tomorrow’s caregivers. Each active staff physician holds a faculty appointment at Case Western Reserve University School of Medicine. Its main campus hospital houses the Cleveland Metropolitan School District’s Lincoln-West School of Science & Health, the only high school in America located inside a hospital.
Knowing that good health is about much more than good medical care, MetroHealth has launched the Institute for H.O.P.E.™ (Health, Opportunity, Partnership, Empowerment), which uses a coordinated, collaborative and strategic approach to help patients with non-medical needs such as healthy food, stable housing and job training.
The MetroHealth Glick Center, a new 11-floor hospital, is under construction on the system’s main campus in Cleveland and is scheduled to welcome its first patients in October 2022. The billion-dollar project is the cornerstone of a wider neighborhood revitalization effort led by the system and its partners in the community.
For more information, visit metrohealth.org.