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Poorer patients with lung cancer are less likely to be given any treatment at all, and the gap is not explained by them being diagnosed later or by which country's health system they are in.
Forrest, Adams, Wareham, Rubin and White searched MEDLINE, EMBASE and Scopus to September 2012 for cohort studies in which receipt of lung cancer treatment was reported by a measure of socioeconomic position. Forty-six papers met the inclusion criteria and 23 entered the meta-analysis.
The framing matters as much as the result: the authors call this an intervention-generated inequality, a variation in outcome produced by how care is organised and delivered rather than by the disease. The gap survived adjustment for stage at presentation and was present across health care systems, including systems free at the point of use.
The deprivation gradient in lung cancer is not only about who gets the disease. Among people who already have it, and at the same stage, poorer patients are less likely to be offered the treatment that works.
Shares Take lung screening scanners to supermarket car parks in the poorest areas, Treat the deprivation gradient in lung cancer as a defect in delivery that can be fixed and measured, Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement, Trials do not represent the people who get cancer and the tag lung-evidence.
Shares Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement, Trials do not represent the people who get cancer, Most of the world has almost no cancer care, Lung cancer (all types) and the tag lung-evidence.
Shares Most of the world has almost no cancer care, Lung cancer (all types), Small-cell lung cancer, Non-small-cell lung cancer and the tag lung-evidence.
Shares Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement, Trials do not represent the people who get cancer, Lung cancer (all types), Non-small-cell lung cancer and the tag lung-evidence.
Shares Performance status (ECOG, Karnofsky), Lung cancer (all types), Non-small-cell lung cancer and the tag lung-evidence.
Shares Close the United Kingdom lung cancer gaps the UK page names: screening rollout, diagnostic pathway, molecular testing and drug access, Lung cancer (all types), Small-cell lung cancer, Non-small-cell lung cancer and the tag lung-evidence.
Shares Performance status (ECOG, Karnofsky), Lung cancer (all types), Non-small-cell lung cancer and the tag lung-evidence.
Shares Performance status (ECOG, Karnofsky), Lung cancer (all types), Non-small-cell lung cancer and the tag lung-evidence.