Mechanisms of Disparities in Etiology and Outcomes of Lung Cancer in the United States: The Role of Risk and Protective Factors (R01/R21)
NIMHD is promoting multidisciplinary research to understand the underlying causal factors and mechanisms that result in lung cancer disparities in U.S. health disparity populations. The objectives are to understand (1) the complex etiological factors (social, cultural, environmental, behavioral or biological) contributing to lung cancer disparities and (2) how health care factors affect morbidity and mortality outcomes among lung cancer patients from health disparity populations.
Lung cancer is the leading cause of cancer-related death among both men and women in the United States. Race/ethnicity and socioeconomic status influence lung cancer incidence and mortality patterns. In 2014, among men, Black/African American men had the highest lung cancer incidence and mortality rates in the United States. Although cigarette smoking is the major risk factor for lung cancer, smoking rates alone do not explain disparities in the development of the disease. For example, higher rates of lung cancer among Blacks occur even though they have lower smoking rates, smoke fewer cigarettes per day, and are less likely to be heavy smokers, compared to Whites. In addition, lung cancer rates vary by education levels, geographic regions, and country of origin among immigrant racial/ethnic minorities. There is a need for comprehensive research to improve our understanding of the causes and mechanisms that contribute to lung cancer disparities.
This joint initiative with the National Cancer Institute supports projects that will focus on lung cancer health disparities causal factors and pathways at multiple levels, including multidisciplinary translational, behavioral, or epidemiological, or health services projects. Studies can involve primary and/or secondary data collection and analysis.
Research topics of specific interest in health disparity populations include, but are not limited to, understanding the influence of social factors with biological factors, genetic and gene-environment interactions; protective factors; differences in lung tumor biology and in metabolism and clearance of carcinogens; influence of social stressors and environmental exposures; etiology of lung cancer among never-smokers, especially women; causes of disparities related to stage of diagnosis and treatment management; and the role of healthcare access and quality in explaining disparities in lung cancer mortality.