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

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  • Lynne F Forrest
  • Jean Adams
  • Helen Wareham
  • Greg Rubin
  • Martin White

Abstract

In a systematic review and meta-analysis, Lynne Forrest and colleagues find that patients with lung cancer who are more socioeconomically deprived are less likely to receive surgical treatment, chemotherapy, or any type of treatment combined, compared with patients who are more socioeconomically well off, regardless of cancer stage or type of health care system. 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

Suggested Citation

  • Lynne F Forrest & Jean Adams & Helen Wareham & Greg Rubin & Martin White, 2013. "Socioeconomic Inequalities in Lung Cancer Treatment: Systematic Review and Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 10(2), pages 1-25, February.
    • Handle: RePEc:plo:pmed00:1001376
    DOI: 10.1371/journal.pmed.1001376
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    Cited by:

    1. Pousette, Andreas & Hofmarcher, Thomas, 2024. "Tackling inequalities in cancer care in the European Union," IHE Report / IHE Rapport 2024:1, IHE - The Swedish Institute for Health Economics.
    2. Klaas H J Ultee & Elke K M Tjeertes & Frederico Bastos Gonçalves & Ellen V Rouwet & Anton G M Hoofwijk & Robert Jan Stolker & Hence J M Verhagen & Sanne E Hoeks, 2018. "The relation between household income and surgical outcome in the Dutch setting of equal access to and provision of healthcare," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-13, January.
    3. Jui-Kun Chiang & Yee-Hsin Kao & Ning-Sheng Lai, 2015. "The Impact of Hospice Care on Survival and Healthcare Costs for Patients with Lung Cancer: A National Longitudinal Population-Based Study in Taiwan," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-19, September.
    4. Ajay Mahal & Lainie Sutton, 2014. "Economic prosperity and non-communicable disease: understanding the linkages," Chapters, in: Raghbendra Jha & Raghav Gaiha & Anil B. Deolalikar (ed.), Handbook on Food, chapter 12, pages 278-324, Edward Elgar Publishing.
    5. Maheswaran, Hendramoorthy & Kupek, Emil & Petrou, Stavros, 2015. "Self-reported health and socio-economic inequalities in England, 1996–2009: Repeated national cross-sectional study," Social Science & Medicine, Elsevier, vol. 136, pages 135-146.
    6. Poon, Charlotte & Haderi, Artes & Roediger, Alexander & Yuan, Megan, 2022. "Should we screen for lung cancer? A 10-country analysis identifying key decision-making factors," Health Policy, Elsevier, vol. 126(9), pages 879-888.
    7. Domantas Jasilionis & Giedre Smailyte & Ieva Vincerzevskiene & Vladimir Shkolnikov, 2015. "Educational differentials in cancer mortality and avoidable deaths in Lithuania, 2001–2009: a census-linked study," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(8), pages 919-926, December.

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