L. Forrest
Socioeconomic Inequalities in Lung Cancer Treatment: Systematic Review and Meta-analysis
Forrest, L.; Adams, J.; Wareham, H.; Rubin, G.P.; White, M.
Authors
J. Adams
H. Wareham
G.P. Rubin
M. White
Abstract
Background: Intervention-generated inequalities are unintended variations in outcome that result from the organisation and delivery of health interventions. Socioeconomic inequalities in treatment may occur for some common cancers. Although the incidence and outcome of lung cancer varies with socioeconomic position (SEP), it is not known whether socioeconomic inequalities in treatment occur and how these might affect mortality. We conducted a systematic review and meta-analysis of existing research on socioeconomic inequalities in receipt of treatment for lung cancer. Methods and Findings: MEDLINE, EMBASE, and Scopus were searched up to September 2012 for cohort studies of participants with a primary diagnosis of lung cancer (ICD10 C33 or C34), where the outcome was receipt of treatment (rates or odds of receiving treatment) and where the outcome was reported by a measure of SEP. Forty-six papers met the inclusion criteria, and 23 of these papers were included in meta-analysis. Socioeconomic inequalities in receipt of lung cancer treatment were observed. Lower SEP was associated with a reduced likelihood of receiving any treatment (odds ratio [OR] = 0.79 [95% CI 0.73 to 0.86], p<0.001), surgery (OR = 0.68 [CI 0.63 to 0.75], p<0.001) and chemotherapy (OR = 0.82 [95% CI 0.72 to 0.93], p = 0.003), but not radiotherapy (OR = 0.99 [95% CI 0.86 to 1.14], p = 0.89), for lung cancer. The association remained when stage was taken into account for receipt of surgery, and was found in both universal and non-universal health care systems. Conclusions: Patients with lung cancer living in more socioeconomically deprived circumstances are less likely to receive any type of treatment, surgery, and chemotherapy. These inequalities cannot be accounted for by socioeconomic differences in stage at presentation or by differences in health care system. Further investigation is required to determine the patient, tumour, clinician, and system factors that may contribute to socioeconomic inequalities in receipt of lung cancer treatment.
Citation
Forrest, L., Adams, J., Wareham, H., Rubin, G., & White, M. (2013). Socioeconomic Inequalities in Lung Cancer Treatment: Systematic Review and Meta-analysis. PLoS Medicine, 10(2), Article e1001376. https://doi.org/10.1371/journal.pmed.1001376
Journal Article Type | Article |
---|---|
Publication Date | Feb 5, 2013 |
Deposit Date | Nov 28, 2012 |
Publicly Available Date | Mar 31, 2014 |
Journal | PLoS Medicine |
Print ISSN | 1549-1277 |
Electronic ISSN | 1549-1676 |
Publisher | Public Library of Science |
Peer Reviewed | Peer Reviewed |
Volume | 10 |
Issue | 2 |
Article Number | e1001376 |
DOI | https://doi.org/10.1371/journal.pmed.1001376 |
Files
Published Journal Article
(840 Kb)
PDF
Copyright Statement
© 2013 Forrest et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
You might also like
Alcohol Use Disorders and Hazardous Drinking among Undergraduates at English Universities
(2011)
Journal Article
Downloadable Citations
About Durham Research Online (DRO)
Administrator e-mail: dro.admin@durham.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search