Racial gaps in lung cancer surgery

A new study published in JAMA found that black patients newly diagnosed with lung cancer were less inclined to have surgery than whites because they did not connect well with their doctors.

Researchers analysed data from 386 lung cancer patients in Carolina and found that only 55% of black patients had surgery compared to 66% of white patients. They found that many black patients misunderstood their prognosis or did not feel comfortable enough to discuss with their doctors treatment options and outcomes. Black patients were also less likely to have other sources of support.

The authors said that there are many barriers to improving the disparities but doctors and hospitals can work on the negative perceptions of patient-physician communications and spend more time with patients about their treatment options.

Source: "Factors Associated With Decisions to Undergo Surgery Among Patients With Newly Diagnosed Early-Stage Lung Cancer". JAMA, 2010; 303 (23): 2368-2376

Knee surgery had no benefit for osteoarthritis

Two studies raising doubts about the effectiveness of knee surgery were published in the New England Journal of Medicine (NEJM).


About 200 patients with moderate-to-severe osteoarthritis of the knee were randomly assigned to receive either surgery, drugs and physical therapy ( as treatment group with arthoscopic surgery ) or drugs and physical therapy alone ( as control group ). (1)


At the end of the study, researchers found that patients in the treatment group had slightly less pain than those in the control group after 3 months, but no significant differences between the two groups after 2 years. Researchers concluded that “arthroscopic surgery for osteoarthritis of the knee provides no additional benefit to optimized physical and medical therapy”. A previous study published in 2003 had similar results.

Another study in the same journal found that MRI scan of middle-age and older people show that meniscal tears in the knee are more common in this age group than previously thought and often without pain or stiffness. The author said "Clinicians who order MRI of the knee should take into account the high prevalence of incidental tears when interpreting the results and planning therapy". (2)


Source 1 :"A Randomized Trial of Arthroscopic Surgery for Osteoarthritis of the Knee." NEJM 2008; 359(11):1097-1107 ( abstract only)


Source 2: "Incidental Meniscal Findings on Knee MRI in Middle-Aged and Elderly Persons Volume" NEJM 2008. 359(11) :1108-1115 ( abstract only)