Lung cancer is the leading cause of cancer mortality in the United States. African American men have the highest incidence and mortality for lung cancer in the US, and yet continue to obtain treatment at lower rates than White patients. The causes of racial disparities in cancer care and treatment are likely multifactorial, requiring both quantitative and qualitative research approaches. This proposal will comprise three projects that aim to shed further light on the causes of racial disparities in lung cancer: (Project 1) to identify further potential causes of racial disparities in lung cancer treatment, using large administrative databases, (Project 2) to examine the role of race in tumor registry under-representation, and (Project 3) to obtain qualitative data investigating themes and perceptions of African-Americans regarding lung cancer. The first and second projects involve secondary data analysis, while the third project will involve collection of qualitative data regarding patient factors that might influence treatment choices. Project 1 proposes to use the SEER-Medicare database to further elucidate the role of gender, race, economics, and racial composition of the hospital in explaining the treatment gap in lung cancer for African Americans. Project 2 will utilize the unique data in the CANCORS initiative to obtain information on tumor registry validity for African Americans. Project 3 is a focus group project that will explore the perception of risk for lung cancer, community knowledge about the disease, fatalism, mistrust of the medical system, as well as perception of the treatment experience of African American lung cancer patients. Racial disparities in cancer care are a pervasive and complex problem that requires a combination of both quantitative and qualitative research methods. The completion of these study projects would further inform the field of disparities, and provide new insights on potential causes racial disparities in lung cancer. The candidate's career plan involves courses in qualitative data analysis, as well as courses in public policy. The education plan, in conjunction with the research projects would give the candidate the training and tools to be a leading researcher in the disparities field.
