少数族裔收益递减理论认为，社会经济成就给黑人带来的健康益处少于白人。当前的研究评估了社会结构对非小细胞肺癌 (NSCLC) 切除率和生存率的影响。使用 2004 年至 2017 年国家癌症数据库确定了 IA 至 IIIA 期潜在可切除 NSCLC 患者。根据人口水平的教育和收入将患者分为四分位数。使用逻辑回归来预测风险调整后的切除率。使用 Cox 比例风险模型评估死亡率。在确定的 416,025 名患者中，213,643 名 (51.4%) 接受了切除术。在白人患者中，最低收入（调整后优势比 0.76，95% 置信区间 0.74-0.78，P < .01）和教育四分位数（调整后优势比 0.82，95% 置信区间 0.79-0.84，P < .01）相关随着切除几率的降低。黑人患者中受教育程度最低的四分位数与较低的切除率无关。收入最低四分位（调整后优势比 0.67，95% CI 0.61-0.74，P < .01）与切除减少相关。教育程度和收入最低四分位数的白人患者 5 年死亡率风险增加（调整后风险比 1.13，95% CI 1.11-1.15，P < .01，调整后风险比 1.08，95% CI 1.06-1.11，P < . 01）。在黑人患者中，教育程度和收入最高四分位数的黑人患者与最低四分位数的黑人患者的 5 年生存率没有显着差异。在非小细胞肺癌黑人患者中，教育程度与切除率增加无关。此外，高等教育和收入与五年生存率的提高无关。与白人患者相比，黑人患者的获益减少，说明在观察到的癌症结果不平等中普遍存在种族特异性机制。版权所有 © 2023 作者。由爱思唯尔公司出版。保留所有权利。

Minorities diminished returns theory posits that socioeconomic attainment conveys fewer health benefits for Black than White individuals. The current study evaluates the effects of social constructs on resection rates and survival for non-small cell lung cancer (NSCLC).Patients with potentially resectable NSCLC stage IA to IIIA were identified using the 2004 to 2017 National Cancer Database. Patients were stratified into quartiles based on population-level education and income. Logistic regression was used to predict risk-adjusted resection rates. Mortality was assessed with Cox proportional hazard modeling.Of the 416,025 patients identified, 213,643 (51.4%) underwent resection. Among White patients, the lowest income (adjusted odds ratio 0.76, 95% confidence interval 0.74-0.78, P < .01) and education quartiles (adjusted odds ratio 0.82, 95% confidence interval 0.79-0.84, P < .01) were associated with decreased odds of resection. The lowest education quartile among Black patients was not associated with lower resection rates. The lowest income quartile (adjusted odds ratio 0.67, 95% CI 0.61-0.74, P < .01) was associated with reduced resection. White patients in the lowest education and income quartiles experienced increased hazard of 5-year mortality (adjusted hazard ratio 1.13, 95% CI 1.11-1.15, P < .01 and adjusted hazard ratio 1.08, 95% CI 1.06-1.11, P < .01 respectively). In Black patients, there were no significant differences in 5-year survival between Black patients in the highest education and income quartiles and those in the lowest quartiles.Among Black patients with NSCLC, educational attainment is not associated with increased resection rates. In addition, higher education and income were not associated with improved 5-year survival. The diminished gains experienced by Black patients, compared to Whites patients, illustrate the presence of pervasive race-specific mechanisms in observed inequalities in cancer outcomes.Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.