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Lookup NU author(s): Dr Lynne Forrest, Professor Martin White, Emeritus Professor Greg RubinORCiD, Dr Jean Adams
Background: Reducing socioeconomic inequalities in lung cancer treatment may reduce survival inequalities. However, the reasons for treatment variation are unclear.Methods: Northern and Yorkshire cancer registry, Hospital Episode Statistics and lung cancer audit data sets were linked. Logistic regression was used to explore the role of stage, histology, performance status and comorbidity in socioeconomic inequalities in lung cancer treatment, for 28 733 lung cancer patients diagnosed in 2006-2010, and in a subgroup with stage recorded (n = 7769, 27%).Results: Likelihood of receiving surgery was significantly lower in the most deprived group (odds ratio (OR) = 0.75, 95% confidence interval (CI) 0.65-0.86); however, the OR was attenuated when including histological subtype (OR = 0.82, 95% CI 0.71-0.96). Patients in the most deprived group were significantly less likely to receive chemotherapy in the fully adjusted full cohort model including performance status (OR = 0.64, 95% CI 0.58-0.72) but not in the staged subgroup model when performance status was included (OR = 0.88, 95% CI 0.72-1.08). Socioeconomic inequalities in radiotherapy were not found.Interpretation: Socioeconomic inequalities in performance status statistically explained socioeconomic inequalities in receipt of chemotherapy in the selective staged subgroup, but not in the full cohort. Socioeconomic variation in histological subtype may account for some of the socioeconomic inequalities in surgery.
Author(s): Forrest LF, White M, Rubin G, Adams J
Publication type: Article
Publication status: Published
Journal: British Journal of Cancer
Year: 2014
Volume: 111
Issue: 3
Pages: 608-618
Print publication date: 10/06/2014
Online publication date: 10/06/2014
Acceptance date: 12/05/2014
Date deposited: 07/08/2015
ISSN (print): 0007-0920
ISSN (electronic): 1532-1827
Publisher: Nature Publishing Group
URL: http://dx.doi.org/10.1038/bjc.2014.310
DOI: 10.1038/bjc.2014.310
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