Introduction: Lung cancer is a leading cause of cancer‐related death worldwide. Racial disparities in lung cancer survival exist between blacks and whites, yet they are limited by categorical definitions of race. We sought to examine the impact of African ancestry on overall survival among blacks and whites with NSCLC cases. Methods: Incident cases of NSCLC in blacks and whites from the prospective Southern Community Cohort Study (N = 425) were identified through linkage with state cancer registries in 12 southern states. Vital status was determined by linkage with the National Death Index and Social Security Administration. We evaluated the impact of African ancestry (as estimated by using genome‐wide ancestry‐informative markers) on overall survival by calculating the time‐dependent area under the curve (AUC) for Cox proportional hazards models, adjusting for relevant covariates such as stage and treatment. We replicated our findings in an independent population of NSCLC cases in blacks. Results: Global African ancestry was not significantly associated with overall survival among NSCLC cases. There was no change in model performance when Cox proportional hazards models with and without African ancestry were compared (AUC = 0.79 for each model). Removal of stage and treatment reduced the average time‐dependent AUC from 0.79 to 0.65. Similar findings were observed in our replication study. Conclusions: Stage and treatment are more important predictors of survival than African ancestry is. These findings suggest that racial disparities in lung cancer survival may disappear with similar early detection efforts for blacks and whites.

中文翻译：

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肺癌生存率的种族差异：分期、治疗和血统的影响


简介：肺癌是全世界癌症相关死亡的主要原因。黑人和白人之间肺癌生存率存在种族差异，但它们受到种族分类定义的限制。我们试图研究非洲血统对患有 NSCLC 病例的黑人和白人总体生存率的影响。方法：通过与南部 12 个州的癌症登记处联系，确定了前瞻性南部社区队列研究 (N = 425) 中黑人和白人的非小细胞肺癌 (NSCLC) 病例。生命状况是通过与国家死亡指数和社会保障管理局的联系来确定的。我们通过计算 Cox 比例风险模型的时间依赖性曲线下面积 (AUC)，调整相关协变量，例如阶段和治疗。我们在黑人非小细胞肺癌病例的独立群体中重复了我们的研究结果。结果：全球非洲血统与 NSCLC 病例的总生存率没有显着相关。当比较具有和不具有非洲血统的 Cox 比例风险模型时，模型性能没有变化（每个模型的 AUC = 0.79）。去除分期和治疗将平均时间依赖性 AUC 从 0.79 降低至 0.65。在我们的复制研究中也观察到了类似的结果。结论：分期和治疗是比非洲血统更重要的生存预测因素。这些发现表明，通过对黑人和白人进行类似的早期检测工作，肺癌生存率的种族差异可能会消失。