TY - JOUR

T1 - Socioeconomic position, stage of lung cancer and time between referral and diagnosis in Denmark, 2001-2008

AU - Dalton, Susanne Oksbjerg

AU - Frederiksen, Flemming B.

AU - Jacobsen, E

AU - Steding-Jessen, M

AU - Østerlind, Kell Erik

AU - Schüz, J

AU - Osler, M

AU - Johansen, Christoffer

PY - 2011/9

Y1 - 2011/9

N2 - INTRODUCTION: We investigated the association between socioeconomic position, stage at diagnosis, and length of period between referral and diagnosis in a nationwide cohort of lung cancer patients.METHODS: Through the Danish Lung Cancer Register, we identified 18,103 persons diagnosed with lung cancer (small cell and non-small cell) in Denmark, 2001-2008, and obtained information on socioeconomic position and comorbidity from nationwide administrative registries. The odds ratio (OR) for a diagnosis of advanced-stage lung cancer (stages IIIB-IV) and for a diagnosis >28 days after referral were analysed by multivariate logistic regression models.RESULTS: The adjusted OR for advanced-stage lung cancer was reduced among persons with higher education (OR, 0.92; 95% confidence interval (CI), 0.84-0.99), was increased in persons living alone (OR, 1.06; 95% CI, 1.01-1.13) and decreased stepwise with increasing comorbidity. Higher education was associated with a reduced OR for >28 days between referral and diagnosis as was high income in early-stage patients. Male gender, age and severe comorbidity were associated with increased ORs in advanced-stage patients.INTERPRETATION: Differences by socioeconomic position in stage at diagnosis and in the period between referral and diagnosis indicate that vulnerable patients presenting with lung cancer symptoms require special attention.

AB - INTRODUCTION: We investigated the association between socioeconomic position, stage at diagnosis, and length of period between referral and diagnosis in a nationwide cohort of lung cancer patients.METHODS: Through the Danish Lung Cancer Register, we identified 18,103 persons diagnosed with lung cancer (small cell and non-small cell) in Denmark, 2001-2008, and obtained information on socioeconomic position and comorbidity from nationwide administrative registries. The odds ratio (OR) for a diagnosis of advanced-stage lung cancer (stages IIIB-IV) and for a diagnosis >28 days after referral were analysed by multivariate logistic regression models.RESULTS: The adjusted OR for advanced-stage lung cancer was reduced among persons with higher education (OR, 0.92; 95% confidence interval (CI), 0.84-0.99), was increased in persons living alone (OR, 1.06; 95% CI, 1.01-1.13) and decreased stepwise with increasing comorbidity. Higher education was associated with a reduced OR for >28 days between referral and diagnosis as was high income in early-stage patients. Male gender, age and severe comorbidity were associated with increased ORs in advanced-stage patients.INTERPRETATION: Differences by socioeconomic position in stage at diagnosis and in the period between referral and diagnosis indicate that vulnerable patients presenting with lung cancer symptoms require special attention.

U2 - 10.1038/bjc.2011.342

DO - 10.1038/bjc.2011.342

M3 - Journal article

VL - 105

SP - 1042

EP - 1048

JO - The British journal of cancer. Supplement

JF - The British journal of cancer. Supplement

SN - 0007-0920

IS - 7

ER -