J Eval Clin Pract. 2006 Oct;12(5):573-82.
http://tinyurl.com/lvv7t

    Explaining inequalities in access to treatment in lung cancer.

        * Jack RH,
        * Gulliford MC,
        * Ferguson J,
        * Moller H.

    Research Assistant, King's College London, Department of Public 
Health Services, London, UK.

    Background Geographical inequalities in lung cancer treatment and 
patient survival have been described. We hypothesized that lung cancer 
patients' access to treatment may be influenced by deprivation and the 
pathway to care.

Methods Case notes were reviewed for patients resident in south-east 
London who were registered with lung cancer at the Thames Cancer 
Registry in 1998. Use of surgery, chemotherapy, radiotherapy or any 
specific treatment and one-year survival were examined. Analyses were 
adjusted for age, sex, histology, stage and basis of diagnosis.

Results Data for 695 out of 958 (73%) patients were analysed. Subjects 
who were initially referred to a specialist in thoracic medicine, 
surgery or oncology were more likely to receive active treatment (71%) 
than subjects who were referred to other consultants (51%) or who were 
admitted as emergencies (42%) (P < 0.0001).

Conclusion Socio-economic deprivation was associated with lower rates of 
treatment and this partly explained variations in survival. Subjects who 
were referred to specialists were more likely to receive active 
treatment and treatment patterns varied between first trust attended.

    PMID: 16987120 [PubMed - in process]

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