Table 5.
Regression Predictors of Decisions Against Lung Cancer Surgery in Patients With Stage 1 or 2 Non–Small Cell Cancer (N = 386)
| Factor | OR (95% CI)a | ||
|---|---|---|---|
| Overall | Black Patients (n = 113) | White Patients (n = 273) | |
| Potentially reversible Belief that diagnosis is <90% certain |
0.37 (0.14–0.93) |
0.43 (0.24–0.78) |
0.26 (0.07–1.00) |
| Feeling that overall quality of life would be worse in 1 year after undergoing surgery | 0.27 (0.14–0.50) | 0.25 (0.08–0.79) | 0.25 (0.17–0.37) |
| Perception of poor cancer communication (score drops 5 of 25 points) | 0.42 (0.32–0.74) | 0.27 (0.15–0.51) | 0.47 (0.24–0.93) |
| No regular source of health care | 0.60 (0.21–1.72) | 0.20 (0.10–0.43) | 1.30 (0.32–5.30) |
| Other Black race |
0.75 (0.57–0.99) |
||
| Increased trust (for each 10-point increase on trust domain of the Primary Care Assessment Survey) | 0.84 (0.71–1.00) | 0.54 (0.35–0.85) | 1.00 (0.76–1.40) |
| Marital status (no current partner) | 1.38 (0.80–2.41) | 0.91 (0.36–2.30) | 0.61 (0.37–0.99) |
| Top quartile in age (>73 y) | 0.32 (0.20–0.51) | 0.48 (0.24–0.96) | 0.33 (0.19–0.58) |
| ≥2 Comorbid conditions | 0.24 (0.08–0.73) | 0.04 (0.01–0.25) | 0.45 (0.10–2.00) |
| Fatalism (10-point increase on mental adjustment to cancer on a 100-point scale) | 0.82 (0.74–0.92) | 0.86 (0.75–0.98) | 0.70 (0.49–0.98) |
| Bottom quartile of physical component score on Short Form 12 | 0.71 (0.38–1.33) | 1.30 (0.19–11.0) | 0.55 (0.32–0.93) |
| Bottom quartile of mental component score on Short Form 12 | 0.51 (0.28–0.91) | 0.85 (0.09–8.30) | 0.55 (0.24–1.23) |
| Religiosity (determined by agreement with the statement: faith alone can cure disease) | 0.56 (0.39–0.79) | 0.81 (0.19–3.50) | 0.34 (0.21–0.56) |
| Lowest 2 tertiles of median household income (vs highest tertile, which is >$38 850) | 0.45 (0.23–0.88) | 0.36 (0.11–1.20) | 0.42 (0.22–0.84) |
Abbreviations: CI, confidence interval; OR, odds ratio.
Model includes sex, education, insurance (private vs other), biopsy confirmation, hospitalization during the previous year, and agreement or disagreement with the following items: (1) physician discusses pros and cons of surgery, (2) prayer can cure cancer, (3) exposure to air during surgery will cause cancer to spread, (4) family must approve surgery, (5) want surgery even if end up in a nursing home, (6) want surgery even if chair-bound postoperatively, (7) some patients get worse care because of race, and (8) Mental Adjustment to Cancer Scale scores for fighting spirit and anxious or preoccupied.