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Lung cancer: deprived patients less likely to receive surgery

Patients living in deprived areas in England are less likely to receive surgical treatment for NSCLC, according to a new study published in the journal Thorax.

The study linked National Cancer Registry data from 31,351 patients with NSCLC to Hospital Episode Statistics and National Lung Cancer Audit data.

Not surprisingly, the strongest predictor for receipt of surgery was disease stage at diagnosis. Poor performance status (as per WHO classification 2, 3 or 4) dramatically reduced the odds of receiving surgery (OR, 0.15; 95% CI, 0.13-0.17).

Surgery was also less likely in patients with congestive heart failure (OR, 0.55; 95% CI, 0.40-0.74), cerebrovascular disease (OR, 0.58; 95% CI, 0.45-0.76) or COPD (OR, 0.50; 95% CI, 0.43-0.57).

Having had a Positron Emission Tomography-CT scan was associated with increased odds of receiving surgery (OR, 3.65; 95% CI, 3.08-4.33). Women were more likely to receive surgery than men (OR, 1.22; 95% CI, 1.08-1.38).

The probability of surgery for early stage disease decreased from least to most deprived patients. The probability of receiving surgery was 86.0% (95% CI, 83.1-88.4) for patients who lived in less deprived areas compared with 78.6% (95% CI, 75.7-81.3) for patients living in more deprived areas.

The authors concluded that, “comorbidities play an important role in whether patients undergo surgery, but do not completely explain the socioeconomic difference observed in early stage patients”.


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