Association of social vulnerability on time-to-treatment for patients with non-small cell lung cancer.

Background: For patients with early-stage non-small cell lung cancer (NSCLC), treatment delays confer worse overall survival. The relationship between social vulnerability and time-to-treatment for NSCLC is unknown.

Methods: Using statewide cancer registry data, patients with localized (N0) NSCLC from 2015 to 2021 were identified. Social Vulnerability Index (SVI) was identified using patient place of residence. Using Poisson regression, the association of time-to-treatment and SVI was evaluated, with subgroup analyses stratifying by first treatment modality.

Results: 10,562 patients were included. Time-to-treatment increased in each subsequent SVI quartile. Compared to the lowest quartile, patients in the highest SVI quartile had longer adjusted time-to-treatment (64.6 vs 61.0 days, IRR 1.06 (95 ​% CI 1.05-1.07), p ​< ​0.001). In subgroup analysis, patients in the highest quartile had longer time-to-treatment for all modalities.

Conclusions: NSCLC patients with higher social vulnerability demonstrate longer time-to-treatment, motivating further work addressing social determinants of health to maximize population-level access to timely lung cancer care.