Socioeconomic differences and lung cancer survival in Germany

• Verfasst von: Finke, Isabelle [VerfasserIn]
• Verfasst von: Behrens, Gundula [VerfasserIn]
• Verfasst von: Schwettmann, Lars [VerfasserIn]
• Verfasst von: Gerken, Michael [VerfasserIn]
• Verfasst von: Pritzkuleit, Ron [VerfasserIn]
• Verfasst von: Holleczek, Bernd [VerfasserIn]
• Verfasst von: Brenner, Hermann [VerfasserIn]
• Verfasst von: Jansen, Lina [VerfasserIn]
• Titel: Socioeconomic differences and lung cancer survival in Germany
• Titelzusatz: investigation based on population-based clinical cancer registration
• Verf.angabe: Isabelle Finke, Gundula Behrens, Lars Schwettmann, Michael Gerken, Ron Pritzkuleit, Bernd Holleczek, Hermann Brenner, Lina Jansen, for the German Cancer Survival Working Group
• E-Jahr: 2020
• Jahr: 4 February 2020
• Umfang: 8 S.
• Illustrationen: Diagramme
• Fussnoten: Gesehen am 15.05.2020
• Titel Quelle: Enthalten in: Lung cancer
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 1985
• Jahr Quelle: 2020
• Band/Heft Quelle: 142(2020), Seite 1-8
• ISSN Quelle: 1872-8332
• DOI: doi:10.1016/j.lungcan.2020.01.021
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Area-based socioeconomic deprivation
• Sach-SW: Germany
• Sach-SW: Lung cancer
• Sach-SW: Stage at diagnosis
• Sach-SW: Survival
• Sach-SW: Treatment
• K10plus-PPN: 1698345402

Abstract

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.