Socioeconomic Inequalities in Lung Cancer Treatment: Systematic Review and Meta-Analysis

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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.

Please see later in the article for the Editors' Summary

Vyšlo v časopise: Socioeconomic Inequalities in Lung Cancer Treatment: Systematic Review and Meta-Analysis. PLoS Med 10(2): e32767. doi:10.1371/journal.pmed.1001376
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001376

Souhrn

Zdroje

1. Cancer Research UK Cancer incidence: UK statistics. Available: http://info.cancerresearchuk.org/cancerstats/incidence/. Accessed 09 January 2013.

2. Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, et al.. (eds). SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD. Based on November 2011 SEER data submission, posted to the SEER web site, April 2012. Available: http://seer.cancer.gov/csr/1975_2009_pops09/. Accessed 09 January 2012.

3. Cancer Research UK Common cancers - UK mortality statistics. Available: http://info.cancerresearchuk.org/cancerstats/mortality/cancerdeaths/. Accessed 09 January 2013.

4. ColemanMP, FormanD, BryantH, ButlerJ, RachetB, et al. (2011) Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995–2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet 377: 127–138.

5. VerdecchiaA, FrancisciS, BrennerH, GattaG, MicheliA, et al. (2007) Recent cancer survival in Europe: a 2000–02 period analysis of EUROCARE-4 data. Lancet Oncol 8: 784–796.

6. NICE (2005) Clinical Guideline 24. Lung Cancer: the diagnosis and treatment of lung cancer. London: NICE.

7. RachetB, EllisL, MaringeC, ChuT, NurU, et al. (2010) Socioeconomic inequalities in cancer survival in England after the NHS cancer plan. Br J Cancer 103: 446–453.

8. AartsMJ, LemmensVEPP, LouwmanMWJ, KunstAE, CoeberghJWW (2010) Socioeconomic status and changing inequalities in colorectal cancer? A review of the associations with risk, treatment and outcome. Eur J Cancer 46: 2681–2695.

9. WoodsLM, RachetB, ColemanMP (2006) Origins of socio-economic inequalities in cancer survival: a review. Ann Oncol 17: 5–19.

10. White M, Adams J, Heywood P (2009) How and why do interventions that increase health overall widen inequalities within populations? In: Babones S, editor. Health, inequality and society. Bristol: Policy Press.

11. SidorchukA, AgardhE, AremuO, HallqvistJ, AllebeckP, et al. (2009) Socioeconomic differences in lung cancer incidence: a systematic review and meta-analysis. Cancer Causes Control 20: 459–471.

12. MoherD, LiberatiA, TetzlaffJ, AltmanDG (2009) The PRISMA Group (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097 doi:10.1371/journal.pmed.1000097.

13. SlatoreCG, AuDH, GouldMK (2010) on behalf of the American Thoracic Society Disparities in Healthcare G (2010) An Official American Thoracic Society Systematic Review: Insurance Status and Disparities in Lung Cancer Practices and Outcomes. Am J Respir Crit Care Med 182: 1195–1205.

14. Donaldson C, Gerard K (2005) Health care financing reforms: moving into the new millenium. Economics of Health Care Financing: The Visible Hand. Basingstoke: Palgrave Macmillan.

15. SIGN (2011) SIGN 50: A Guideline Developer's Handbook. Methodology Checklist 3: Cohort studies. Edinburgh: SIGN.

16. VandenbrouckeJP, von ElmE, AltmanDG, GøtzschePC, MulrowCD, et al. (2007) Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration. PLoS Med 4(10): e297 doi:10.1371/journal.pmed.0040297.

17. The Cochrane Collaboration (2008) Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.2. Higgins J, Green S, editors.

18. ErridgeSC, MurrayB, WilliamsL, BrewsterD, BlackR, et al. (2009) Improved survival from lung cancer in British Columbia compared to Scotland-Are different treatment rates the whole story? Lung Cancer 64: 358–366.

19. BerglundA, HolmbergL, TishelmanC, WageniusG, EakerS, et al. (2010) Social inequalities in non-small cell lung cancer management and survival: a population-based study in central Sweden. Thorax 65: 327–333.

20. DaltonSO, FrederiksenBL, JacobsenE, Steding-JessenM, OsterlindK, et al. (2011) Socioeconomic position, stage of lung cancer and time between referral and diagnosis in Denmark, 2001–2008. Br J Cancer 105: 1042–1048.

21. RichAL, TataLJ, FreeCM, StanleyRA, PeakeMD, et al. (2011) Inequalities in outcomes for non-small cell lung cancer: the influence of clinical characteristics and features of the local lung cancer service. Thorax 66: 1078–1084.

22. BerglundA, LambeM, LüchtenborgM, LinklaterK, PeakeMD, et al. (2012) Social differences in lung cancer management and survival in South East England: a cohort study. BMJ Open 2 doi:10.1136/bmjopen-2012-001048.

23. StevensW, StevensG, KolbeJ, CoxB (2007) Lung cancer in New Zealand: Patterns of secondary care and implications for survival. J Thorac Oncol 2: 481–493.

24. WelchV, PetticrewM, UeffingE, Benkhalti JanduM, BrandK, et al. (2012) Does Consideration and Assessment of Effects on Health Equity Affect the Conclusions of Systematic Reviews? A Methodology Study. PLoS ONE 7(3): e31360 doi:10.1371/journal.pone.0031360.

25. ThomasS, FayterD, MissoK, OgilvieD, PetticrewM, et al. (2008) Population tobacco control interventions and their effects on social inequalities in smoking: systematic review. Tob Control 17: 230–237.

26. EggerM, SchneiderM, SmithGD (1998) Meta-analysis Spurious precision? Meta-analysis of observational studies. BMJ 316: 140–144.

27. IoannidisJ, PatsopoulosN, EvangelouE (2007) Uncertainty in heterogeneity estimates in meta-analyses. BMJ 335: 914–916.

28. OgilvieD, FayterD, PetticrewM, SowdenA, ThomasS, et al. (2008) The harvest plot: A method for synthesising evidence about the differential effects of interventions. BMC Med Res Methodol 8: 8.

29. AdamsJ, RyanV, WhiteM (2005) How accurate are Townsend Deprivation Scores as predictors of self-reported health? A comparison with individual level data. J Public Health 27: 101–106.

30. OlssonJK, SchultzEM, GouldMK (2009) Timeliness of care in patients with lung cancer: a systematic review. Thorax 64: 749–756.

31. GroseD, DevereuxG, BrownL, JonesR, SharmaD, et al. (2011) Variation in comorbidity and clinical management in patients newly diagnosed with lung cancer in four Scottish centers. J Thorac Oncol 6: 500–509.

32. HallSE, BulsaraCE, BulsaraMK, LeahyTG, CulbongMR, et al. (2004) Treatment patterns for cancer in Western Australia: Does being indigenous make a difference? Med J Aust 181: 191–194.

33. McCannJ, ArtinianV, DuhaimeL, LewisJW, KvalePA, et al. (2005) Evaluation of the Causes for Racial Disparity in Surgical Treatment of Early Stage Lung Cancer. Chest 128: 3440–3446.

34. RiazSP, LüchtenborgM, JackRH, CouplandVH, LinklaterKM, et al. (2012) Variation in surgical resection for lung cancer in relation to survival: Population-based study in England 2004–2006. Eur J Cancer 48: 54–60.

35. CampbellNC, ElliottAM, SharpL, RitchieLD, CassidyJ, et al. (2002) Impact of deprivation and rural residence on treatment of colorectal and lung cancer. Br J Cancer 87: 585–590.

36. CrawfordSM, SauerzapfV, HaynesR, ZhaoH, FormanD, et al. (2009) Social and geographical factors affecting access to treatment of lung cancer. Br J Cancer 101: 897–901.

37. ErridgeSC, ThomsonCS, DavidsonJ, JonesRD, PriceA (2002) Factors Influencing the Use of Thoracic Radiotherapy in Lung Cancer;an Analysis of the 1995 Scottish Lung Cancer Audit. Clin Oncol 14: 219–227.

38. GregorA, ThomsonCS, BrewsterDH, StronerPL, DavidsonJ, et al. (2001) Management and survival of patients with lung cancer in Scotland diagnosed in 1995: results of a national population based study. Thorax 56: 212–217.

39. JackRH, GullifordMC, FergusonJ, MollerH (2003) Geographical inequalities in lung cancer management and survival in South East England: evidence of variation in access to oncology services? Br J Cancer 88: 1025–1031.

40. JackRH, GullifordMC, FergusonJ, MøllerH (2006) Explaining inequalities in access to treatment in lung cancer. J Eval Clin Pract 12: 573–582.

41. JonesAP, HaynesR, SauerzapfV, CrawfordSM, ZhaoH, et al. (2008) Travel time to hospital and treatment for breast, colon, rectum, lung, ovary and prostate cancer. Eur J Cancer 44: 992–999.

42. MahmudSM, ReillyM, ComberH (2003) Patterns of initial management of lung cancer in the Republic of Ireland: a population-based observational study. Lung Cancer 41: 57–64.

43. McMahonM, BarbiereJM, GreenbergDC, WrightKA, LyratzopoulosG (2011) Population-based trends in use of surgery for non-small cell lung cancer in a UK region, 1995–2006. Thorax 66: 453–455.

44. PollockAM, VickersN (1998) Deprivation and emergency admissions for cancers of colorectum, lung, and breast in south east England: ecological study. BMJ 317: 245–252.

45. RaineR, WongW, ScholesS, AshtonC, ObichereA, et al. (2010) Social variations in access to hospital care for patients with colorectal, breast, and lung cancer between 1999 and 2006: retrospective analysis of hospital episode statistics. BMJ 340.

46. RichAL, TataLJ, StanleyRA, FreeCM, PeakeMD, et al. (2011) Lung cancer in England: Information from the National Lung Cancer Audit (LUCADA). Lung Cancer 72: 16–22.

47. StevensW, StevensG, KolbeJ, CoxB (2008) Ethnic differences in the management of lung cancer in New Zealand. J Thorac Oncol 3(3): 237–244.

48. BattersbyJ, FlowersJ, HarveyI (2004) An alternative approach to quantifying and addressing inequity in healthcare provision: access to surgery for lung cancer in the east of England. J Epidemiol Community Health 58: 623–625.

49. BendzsakA, NenshiR, DarlingG, SchultzSE, GunrajN, et al. (2011) Overview of Lung Cancer Surgery in Ontario. Ann Thorac Surg 91: 361–366.

50. CartmanML, HatfieldAC, MuersMF, PeakeMD, HawardRA, et al. (2002) Lung cancer: district active treatment rates affect survival. J Epidemiol Community Health 56: 424–429.

51. HuiAC, VinodSK, JalaludinBB, YuileP, DelaneyGP, et al. (2005) Socio-economic status and patterns of care in lung cancer. Aust N Z J Public Health 29: 372–377.

52. MadelaineJ, GuizardAV, LefevreH, LecarpentierMM, LaunoyG (2002) [Diagnosis, treatment, and prognosis of lung cancer in the Manche (France) (1997–1999) according to patients socioeconomic characteristics]. Revue d Epidemiologie et de Sante Publique 50: 383–392.

53. PaganoE, FilippiniC, Di CuonzoD, RuffiniE, ZanettiR, et al. (2010) Factors affecting pattern of care and survival in a population-based cohort of non-small-cell lung cancer incident cases. Cancer Epidemiol 34: 483–489.

54. PatelN, AdatiaR, MellemgaardA, JackR, MollerH (2007) Variation in the use of chemotherapy in lung cancer. Br J Cancer 96: 886–890.

55. StevensG, StevensW, PurchuriS, KolbeJ, CoxB (2009) Radiotherapy utilisation in lung cancer in New Zealand: Disparities with optimal rates explained. N Z Med J 122(1306): 43–54.

56. YounisT, Al-FayeaT, VirikK, MorzyckiW, Saint-JacquesN (2008) Adjuvant chemotherapy uptake in non-small cell lung cancer. J Thorac Oncol 3: 1272–1278.

57. BradleyCJ, DahmanB, GivenCW (2008) Treatment and Survival Differences in Older Medicare Patients With Lung Cancer as Compared With Those Who Are Dually Eligible for Medicare and Medicaid. J Clin Oncol 26: 5067–5073.

58. DavidoffAJ, TangM, SealB, EdelmanMJ (2010) Chemotherapy and Survival Benefit in Elderly Patients With Advanced Non–Small-Cell Lung Cancer. J Clin Oncol 28: 2191–2197.

59. EarleCC, VendittiLN, NeumannPJ, GelberRD, WeinsteinMC, et al. (2000) Who Gets Chemotherapy for Metastatic Lung Cancer?. Chest 117: 1239–1246.

60. EsnaolaNF, GebregziabherM, KnottK, FinneyC, SilvestriGA, et al. (2008) Underuse of Surgical Resection for Localized, Non-Small Cell Lung Cancer Among Whites and African Americans in South Carolina. Ann Thorac Surg 86: 220–227.

61. GreenwaldHP, PolissarNL, BorgattaEF, McCorkleR, GoodmanG (1998) Social Factors, Treatment, and Survival in Early-Stage Non-Small Cell Lung Cancer. Am J Public Health 88: 1681–1684.

62. HardyD, LiuC-C, XiaR, CormierJN, ChanW, et al. (2009) Racial disparities and treatment trends in a large cohort of elderly black and white patients with nonsmall cell lung cancer. Cancer 115: 2199–2211.

63. HaymanJA, AbrahamsePH, LakhaniI, EarleCC, KatzSJ (2007) Use of Palliative Radiotherapy Among Patients With Metastatic Non-Small-Cell Lung Cancer. Int J Radiation Oncology Biol Phys 69: 1001–1007.

64. LathanCS, NevilleBA, EarleCC (2008) Racial composition of hospitals: Effects on surgery for early-stage non-small-cell lung cancer. J Clin Oncol 26(26): 4347–4352.

65. PolednakAP (2001) Disaparities in surgical treatment of early-stage non-small-cell lung cancer. Yale J Biol Med 74: 309–314.

66. SmithTJ, PenberthyL, DeschCE, WhittemoreM, NewschafferC, et al. (1995) Differences in initial treatment patterns and outcomes of lung cancer in the elderly. Lung Cancer 13: 235–252.

67. BachPB, CramerLD, WarrenJL, BeggCB (1999) Racial differences in the treatment of early-stage lung cancer. N Engl J Med 341: 1198–1205.

68. EarleCC, NeumannPJ, GelberRD, WeinsteinMC, WeeksJC (2002) Impact of Referral Patterns on the Use of Chemotherapy for Lung Cancer. J Clin Oncol 20: 1786–1792.

69. LathanCS, NevilleBA, EarleCC (2006) The effect of race on invasive staging and surgery in non-small-cell lung cancer. J Clin Oncol 24: 413–418.

70. OuSHI, ZellJA, ZiogasA, Anton-CulverH (2008) Low socioeconomic status is a poor prognostic factor for survival in stage I nonsmall cell lung cancer and is independent of surgical treatment, race, and marital status. Cancer 112: 2011–2020.

71. SugaJM, NguyenDV, MohammedSM, BrownM, CalhounR, et al. (2010) Racial disparities on the use of invasive and noninvasive staging in patients with non-small cell lung cancer. J Thorac Oncol 5: 1772–1778.

72. TammemagiCM, Neslund-DudasC, SimoffM, KvaleP (2004) In lung cancer patients, age, race-ethnicity, gender and smoking predict adverse comorbidity, which in turn predicts treatment and survival. J Clin Epidemiol 57: 597–609.

73. WangJ, KuoY, FreemanJ, GoodwinJ (2008) Increasing access to medical oncology consultation in older patients with stage II-IIIA non-small-cell lung cancer. Med Oncol 25: 125–132.

74. YangR, CheungMC, ByrneMM, HuangY, NguyenD, et al. (2010) Do racial or socioeconomic disparities exist in lung cancer treatment? Cancer 116: 2437–2447.