Differences in treatment decision-making for non-small cell lung cancer among patients and physicians, by race and ethnicity

Despite declining lung cancer death rates, minoritized patients still face health disparities compared to White patients. This study examines treatment preferences and decision-making differences among patients with non-small cell lung cancer (NSCLC) and physicians from different racial and ethnic backgrounds in the US. Two cross-sectional online surveys were conducted from March to May 2023. Respondents were recruited from an NSCLC community and research panel. Recruitment goals were set to ensure diversity, by having African American or Black (hereafter, Black), Asian, Hispanic, and White patients and physicians included. Data were summarized using descriptive statistics. Across all racial and ethnic groups (<i>N</i> = 157), patients reported that extending life was the most important treatment attribute. Hispanic patients assigned more importance to treatment side effect (SE) risks compared to Asian, Black, and White patients. Larger proportions of Asian (63%) and White (73%) patients prioritized quality over quantity of life compared to Black (43%) and Hispanic (40%) patients. All physician groups ranked expected overall survival, progression-free survival, and duration of response as the top three treatment attributes. On a scale of 1 (high) to 10 (low), Black physicians expressed less concern about potential SEs (6.6) than other physician groups (≤5.3). Cost of treatment was consistently ranked with lower importance; however, over 80% of Black and Hispanic physicians thought that patient out-of-pocket costs or financial status were somewhat more or very important to their treatment recommendations. Patients and physicians of different racial and ethnic backgrounds may place varying importance on several treatment attributes.