Influence of Nonmedical Factors in the Choice of Lung Cancer Treatment

To the Editor: Greenberg et al. (March 10 issue)¹ suggest that nonmedical factors influence the treatment received by persons given a diagnosis of non-small-cell lung cancer. The authors acknowledge that their findings are derived from a predominantly rural population whose disease was diagnosed over a decade ago (between 1973 and 1976). Using more contemporary data (1984 to 1986) obtained as part of a prospective, population-based study of the treatment patterns in patients with newly diagnosed disease in Rhode Island, we also observed that certain patients with non-small-cell lung cancer are treated differently, possibly for reasons independent of their clinical condition.