Socioeconomic position, stage of lung cancer and time between referral and diagnosis in Denmark, 2001–2008
2011

Socioeconomic Factors and Lung Cancer Diagnosis in Denmark

Sample size: 18103 publication 10 minutes Evidence: high

Author Information

Author(s): Dalton S O, Frederiksen B L, Jacobsen E, Steding-Jessen M, Østerlind K, Schüz J, Osler M, Johansen C

Primary Institution: Danish Cancer Society

Hypothesis

Patients’ overall knowledge, reflecting their ability to interpret symptoms, communicate and access health services, is closely related to their educational status.

Conclusion

Vulnerable lung cancer patients, particularly those with lower socioeconomic status, are at higher risk for advanced-stage diagnosis and longer waiting times between referral and diagnosis.

Supporting Evidence

  • Patients with higher education had a reduced odds ratio for advanced-stage lung cancer.
  • Living alone was associated with an increased odds ratio for advanced-stage lung cancer.
  • Comorbidity was associated with lower odds ratios for advanced-stage disease.

Takeaway

People with less education and those who live alone may take longer to get diagnosed with lung cancer and may be diagnosed at a more advanced stage.

Methodology

The study analyzed data from the Danish Lung Cancer Register and used multivariate logistic regression models to assess the relationship between socioeconomic factors and lung cancer stage at diagnosis.

Potential Biases

Potential misclassification of exposure due to reliance on administrative data and the inability to distinguish between severity of comorbid conditions.

Limitations

The study could not adjust for smoking status or explore the mechanisms underlying the associations due to lack of data on symptom onset and delays in seeking medical help.

Participant Demographics

The cohort included 18,103 lung cancer patients aged 30 years and older, with varying levels of education and socioeconomic status.

Statistical Information

P-Value

p<0.001

Confidence Interval

0.84–0.99

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1038/bjc.2011.342

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