Evaluating barriers to timely NSCLC treatment: A northern Nevada perspective.

Abstract

e23074 Background: Renown Regional Medical Center (RRMC) in Reno, Nevada, serves as a primary treatment center for non-small cell lung cancer (NSCLC) patients from Washoe County and rural Nevada. Timeliness of treatment is critical in improving NSCLC outcomes. Sociodemographic factors, including sex, rural versus urban residency, race, and actionable mutation status, may significantly influence treatment access and timeliness of care. Considering the unique population dynamics of northern Nevada, we aimed to evaluate how these factors impact treatment patterns and overall outcomes in our specific cohort. Methods: Retrospective data analysis was performed on NSCLC patients stage 1-IV treated at RRMC in Northern Nevada from January 2023 to January 2024. Timelines between the first symptom, diagnosis, and treatment initiation were compared by sex, distance from treatment centers ( > 30 miles vs. ≤30 miles), race (White vs. Non-White), and actionable mutation status (EGFR, ALK, ROS1, KRAS G12C, MET, BRAF, NTRK, RET and HER2). Median time intervals, interquartile ranges, and distributions of rural/urban residence and sex were analyzed, and statistical significance was assessed using P values. Continuous variables (time) were described by median along with the interquartile range (25 th -75 th percentiles) due to the non-normal distribution of the data. Categorical variables (Sex, region, cancer stage) were described in the form of frequency and percentage. Results: The median first symptom to treatment interval was 33.5 days shorter for females (104 days) than males (137.5 days) (P = 0.010). The median time between diagnosis to treatment interval was 45 days for females vs. 65 days for males (P = 0.018). No significant differences were found between first symptom to treatment or initial diagnosis to treatment intervals based on proximity to care ( > 30 miles vs. ≤30 miles) (P = 0.845 and P = 0.478, respectively).There were no significant differences in first symptom to treatment or initial diagnosis to treatment intervals between White and Non-White patients (P = 0.656 and P = 0.305 respectively).There were no significant differences in first symptom to treatment intervals between patients with and without actionable mutations (P = 0.830). Conclusions: Previous research has identified that male gender is an independent unfavorable prognostic indicator for NSCLC survival. Our findings align with this, demonstrating that men have longer delays in care. Preliminary findings suggest significant sex-based disparities in treatment timeliness for NSCLC in Northern Nevada, with males experiencing prolonged delays in care. Interestingly, no significant differences were observed based on distance from primary residence to RRMC, race, or actionable mutation status. These results underscore the critical need to address barriers to equitable care, particularly those exacerbating sex-based disparities in treatment delays.