Black patients with pulmonary fibrosis are significantly younger than their Hispanic and white counterparts across a wide variety of disease metrics, including diagnosis, first hospitalization, lung transplant and death, according to new research published in JAMA Open Network.
“…We saw that Black patients’ experience with the disease is accelerated by about 10 years,” said lead author Ayodeji Adegunsoye, MD, MS, Assistant Professor of Medicine at UChicago Medicine. Adegunsoye and colleagues analyzed outcomes data from 4,500 PF patients from four US hospitals across 18 years (2003-2021) and found that:
- Black patients were diagnosed with pulmonary fibrosis at an average age of 57.9 years, compared to 68.6 years for white patients.
- Black patients were less likely to be male compared to white and Hispanic patients
- Black patients were more likely to be hospitalized compared to white and Hispanic patients
- Black patients were consistently younger at the time of their first hospitalization, lung transplant and death than white and Hispanic patients
“These results are so profound that I believe we should be screening everyone for pulmonary fibrosis earlier, especially if a patient has any risk factors,” Adegunsoye said. “If you can pick up the disease sooner, the outcomes will improve. We know more about the disease now than we did even 10 years ago, and while there is no cure, there are treatments available — some of them are as simple as changing your environment or wearing a mask to reduce environmental exposure, but there are also drugs that can slow the progression of the disease.
Pulmonary fibrosis has been linked to a number of risk factors, including a rheumatoid arthritis diagnosis, exposure to air pollution, occupations that place an individual at high risk of inhaling particulate matter and smoking. The researchers believe the disparities seen in the study are likely linked to lifestyle and socioeconomic factors that put Black patients at a higher risk of environmental exposures.
“For example, Black people are more likely to live along transit corridors, exposing them to more air pollution,” Adegunsoye said. “They’re also more likely to be underinsured or uninsured. Being Black is not the health risk; it’s the environmental and societal factors that make it difficult for Black patients to access high-quality care.”
The results highlight the need for policy changes to raise awareness about the risks and symptoms of the condition and to encourage prophylactic screenings when warranted. Adegunsoye pointed to recent changes in the recommendations for colorectal cancer screenings, spurred by research showing that Black patients were more likely to be diagnosed at a younger age.
“People should be aware that not every cough is a sign of pulmonary fibrosis, but patients and their care teams need to evaluate such symptoms carefully. The earlier we can intervene in this disease, the longer we can give patients to enjoy their lives.”