Socioeconomic differences and lung cancer survival in Germany : investigation based on population-based clinical cancer registration / Isabelle Finke, Gundula Behrens, Lars Schwettmann, Michael Gerken, Ron Pritzkuleit, Bernd Holleczek, Hermann Brenner, Lina Jansen, for the German Cancer Survival Working Group

Objectives - Studies from several countries reported socioeconomic inequalities in lung cancer survival. Hypothesized reasons are differences in cancer care or tumor characteristics. We investigated associations of small-area deprivation and lung cancer survival in Germany and the possible impact of differences in patient, tumor or treatment factors. - Materials and Methods - Patients registered with a primary tumor of the lung between 2000-2015 in three German population-based clinical cancer registries were included. Area-based socioeconomic deprivation on municipality level was measured with the categorized German Index of Multiple Deprivation. Association of deprivation with overall survival was investigated with Cox regression models. - Results - Overall, 22,905 patients were included. Five-year overall survival from the least to the most deprived quintile were 17.2%, 15.9%, 16.7%, 15.7%, and 14.4%. After adjustment for patient and tumor factors, the most deprived group had a lower survival compared to the least deprived group (Hazard Ratio (HR) 1.06, 95% confidence interval (CI) 1.01-1.11). Subgroup analyses revealed lower survival in the most deprived compared to the least deprived quintile in patients with stage I-III [HR: 1.14, 95% CI: 1.06-1.22]. The association persisted when restricting to patients receiving surgery but was attenuated for subgroups receiving either chemotherapy or radiotherapy. - Conclusion - Our results indicate differences in lung cancer survival according to area deprivation in Germany, which were more pronounced in patients with I-III stage cancer. Future research should address in more detail the underlying reasons for the observed inequalities and possible approaches to overcome them.

Saved in:
Persons: Finke, Isabelle [Author]; Behrens, Gundula [Author]; Schwettmann, Lars [Author]; Gerken, Michael [Author]; Pritzkuleit, Ron [Author]; Holleczek, Bernd [Author]; Brenner, Hermann [Author]; Jansen, Lina [Author]
Format: eArticle
Language(s):English
Publication:4 February 2020
Part of:Lung cancer 142(2020), Seite 1-8
Subjects:Area-based socioeconomic deprivation
Germany
Lung cancer
Stage at diagnosis
Survival
Treatment
Notes:Gesehen am 15.05.2020
Physical description:Diagramme
8
ISSN:1872-8332
DOI:10.1016/j.lungcan.2020.01.021