Sex-based disparities in interval time to receipt of surgical treatment of invasive lung cancer in Tennessee
9 affiliations
- 1Department of Public Health, California State University, Fullerton
- 2Department of Mathematics and Statistical Sciences, Jackson State University
- 3Department of Applied Data Science, San Jose State University
- 4Division of Adolescent Medicine, Indiana University School of Medicine
- 5Tennessee Department of Health, Tennessee Cancer Registry
- 6Department of Health Services Management and Policy, College of Public Health, East Tennessee State University
- 7National Healthy Start Association
- 8Department of Cancer Immunology, Oslo University Hospital
- 9Department of Mathematics and Statistics, College of Liberal Arts and Sciences, Mercer University
Abstract
Background The time from diagnosis to the receipt of surgical treatment can impact patients’ survival. This study examines the sex-based disparities in the interval time to receipt of surgical treatment (ITRST) of invasive lung cancer (LC). Method We analyzed retrospective Tennessee Cancer Registry data from 12,113 invasive LC patients aged 18 years or older who received surgical treatment within 52 weeks of diagnosis from 2005 to 2015. Kruskal-Wallis tests were conducted to determine the difference in ITRST within and between groups. Adjusted multivariable Cox regression analyses were conducted to examine the independent variables associated with delayed ITRST of LC among males and females. Results There was a significant difference in ITRST between males and females. Decreased risk of delay ITRST was associated with increasing age among females (adjusted hazard ratio [aHR] = 0.59–0.70; p = 0.001–0.006), but not among males. Black patients were less likely to delay surgical treatment compared to Whites (aHR = 0.76–0.81; P < 0.001). Married patients overall (aHR = 1.23, p < 0.001), males (aHR = 1.26, p < 0.001), and females (aHR = 1.19, p = 0.008) were more likely to delay surgery than unmarried patients. Appalachian patients (overall aHR = 1.06; p = 0.026) were more likely to delay surgery compared to non-Appalachian patients. Patients with public insurance overall (aHR = 1.30, p < 0.001), males (aHR = 1.30, p = 0.023), and females (aHR = 1.28, p = 0.025) had an increased risk of delayed surgery than those with private insurance, compared to self-pay/uninsured. Conclusion Delayed ITRST for invasive LC is more likely among males, married patients, residents of the Appalachian region, and those with public insurance. These findings identify demographic, geographic, and healthcare-related factors associated with variation in treatment timing among Tennessee patients who ultimately underwent surgical treatment for invasive lung cancer.
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BibTeX
@article{mamudu2026sexbased,
title = {{Sex-based disparities in interval time to receipt of surgical treatment of invasive lung cancer in Tennessee}},
author = {Lohuwa Mamudu and Nathan Ballew and Alberto Murguia and Erasmus Tetteh-Bator and Mohammad Masum and Fortenberry J. Dennis and Martin Whiteside and Hadii M. Mamudu and Saanie Sulley and Theophilus Q. Asenso and Paul H. Atandoh},
journal = {Discover Public Health},
year = {2026},
month = oct,
doi = {10.1186/s12982-026-02756-7},
url = {https://doi.org/10.1186/s12982-026-02756-7},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sex-based disparities in interval time to receipt of surgical treatment of invasive lung cancer in Tennessee
AU - Lohuwa Mamudu
AU - Nathan Ballew
AU - Alberto Murguia
AU - Erasmus Tetteh-Bator
AU - Mohammad Masum
AU - Fortenberry J. Dennis
AU - Martin Whiteside
AU - Hadii M. Mamudu
AU - Saanie Sulley
AU - Theophilus Q. Asenso
AU - Paul H. Atandoh
PY - 2026
DA - 2026/10/25
JO - Discover Public Health
DO - 10.1186/s12982-026-02756-7
UR - https://doi.org/10.1186/s12982-026-02756-7
AB - Background The time from diagnosis to the receipt of surgical treatment can impact patients’ survival. This study examines the sex-based disparities in the interval time to receipt of surgical treatment (ITRST) of invasive lung cancer (LC). Method We analyzed retrospective Tennessee Cancer Registry data from 12,113 invasive LC patients aged 18 years or older who received surgical treatment within 52 weeks of diagnosis from 2005 to 2015. Kruskal-Wallis tests were conducted to determine the difference in ITRST within and between groups. Adjusted multivariable Cox regression analyses were conducted to examine the independent variables associated with delayed ITRST of LC among males and females. Results There was a significant difference in ITRST between males and females. Decreased risk of delay ITRST was associated with increasing age among females (adjusted hazard ratio [aHR] = 0.59–0.70; p = 0.001–0.006), but not among males. Black patients were less likely to delay surgical treatment compared to Whites (aHR = 0.76–0.81; P < 0.001). Married patients overall (aHR = 1.23, p < 0.001), males (aHR = 1.26, p < 0.001), and females (aHR = 1.19, p = 0.008) were more likely to delay surgery than unmarried patients. Appalachian patients (overall aHR = 1.06; p = 0.026) were more likely to delay surgery compared to non-Appalachian patients. Patients with public insurance overall (aHR = 1.30, p < 0.001), males (aHR = 1.30, p = 0.023), and females (aHR = 1.28, p = 0.025) had an increased risk of delayed surgery than those with private insurance, compared to self-pay/uninsured. Conclusion Delayed ITRST for invasive LC is more likely among males, married patients, residents of the Appalachian region, and those with public insurance. These findings identify demographic, geographic, and healthcare-related factors associated with variation in treatment timing among Tennessee patients who ultimately underwent surgical treatment for invasive lung cancer.
SN - 3005-0774
ER -