Association between patient-physician relationship and overall survival among African Americans with lung cancer: the Detroit Research on Cancer Survivors study.

BACKGROUND

African Americans with lung cancer experience disparities in overall survival (OS) outcomes. The association between patient-physician relationships on survival differences is not well understood. This study examined the association between patient-physician relationship and OS among African American non-small cell lung cancer (NSCLC) survivors from the Detroit Research on Cancer Survivors (ROCS) cohort.

METHODS

Patients with NSCLC completed baseline and yearly follow-up surveys. The baseline survey included the interpersonal process of care (IPC). Cox regression analysis was performed to evaluate variable associations with survival.

RESULTS

From the ROCS cohort, 398 NSCLC survivors were included with an average age of 63 years. Stage at diagnosis was equally represented: 33.3% local, 33.3% regional, and 33.5% distant. The majority of participants (55.4%) reported experiencing racial discrimination in their lives and 19.2% perceived that they received worse medical care due to discrimination. For IPC measures, optimal scores were explaining results (75.0%), demonstrating compassion (61.7%), and eliciting patient's concerns (56.8%). Patients who underwent surgery were more likely to report optimal scores for eliciting patient's concerns compared to those not treated with surgery (46.1% vs. 35.8%, P<0.05). An optimal score for eliciting patients' concerns showed a suggestive association with improved OS in adjusted analyses [hazard ratio (HR) 0.69, P=0.04].

CONCLUSIONS

Among African American NSCLC perceived discrimination was common, while patient-physician relationship scores were generally favorable across some domains. Optimal patient-physician relationship scores were associated with undergoing surgery and showed a suggestive association with improved OS.