Factors influencing management and outcome in non-small cell lung cancer: the role of socioeconomic status, age, geographic region of origin and aspects of quality of life

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MARC

Willén, Linda,1979-Umeå universitet,Onkologi (author)

Factors influencing management and outcome in non-small cell lung cancer : the role of socioeconomic status, age, geographic region of origin and aspects of quality of life

BookEnglish2023

Publisher, publication year, extent ...

Umeå :Umeå University,2023
105 s.
electronicrdacarrier

Numbers

LIBRIS-ID:oai:DiVA.org:umu-205681
ISBN:9789180700160
ISBN:9789180700177
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-205681URI

Supplementary language notes

Language:English
Summary in:English

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SwePubSwePub

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Subject category:vet swepub-contenttype
Subject category:dok swepub-publicationtype

Varying forms of title

Faktorer som påverkar omhändertagande och överlevnad vid icke-småcellig lungcancer :inverkan av socioekonomi, ålder och ursprung samt aspekter av livskvalitet

Series

Umeå University medical dissertations,0346-6612 ;2231

Notes

Yearly, 4,200 individuals in Sweden are diagnosed with lung cancer, of which 85 % are non-small cell lung cancer (NSCLC). The aims of this thesis were to investigate aspects of equality of care and outcomes in patients with NSCLC and to examine indicators of quality of life. All studies used data in Lung Cancer Database Sweden (LCBaSe), a research database generated by record linkages between the National Lung Cancer Register and other population-based registers. We identified 40,000 patients with NSCLC diagnosed between 2002 and 2016.Paper I examined influence of socioeconomic status. Patients with a high educational level were more often offered PET-CT, assessed in a multidisciplinary team setting, treated with stereotactic body radiotherapy and had better survival in early-, but not in late-stage disease.Paper II investigated elderly NSCLC patients. No difference in stage was seen in patients ≤ 84 years, nor in diagnostic intensity <80 years. Treatment intensity was adapted according to age. Survival differed across age groups in early-, but not late-stage disease.Paper III examined immigrants. We found evidence of a “healthy migrant effect”. There were only small differences in management and outcome. If anything, non-Nordic immigrants had better survival in early-stage disease. Paper IV assessed psychological impact following a NSCLC diagnosis. Higher rates of depression, anxiety, intoxication and suicide were seen in NSCLC patients compared to lung cancer free individuals. The risk of depression, anxiety and suicide decreased over time but the increased risk of intoxication remained throughout the follow-up period.In summary, we found equal access of care and only minor differences in patterns of management and outcomes according to socioeconomic status, age and geographic region of origin. New diagnostics and treatment modalities need to be quickly introduced to enable equal access across socioeconomic groups. A careful assessment of older patients is important to avoid age-biased clinical decision-making. A diagnosis of NSCLC impacts psychological aspects of quality of life and active measures to identify and treat depression and anxiety as well as to identify patients at risk of intoxication and suicide is necessary.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
Lung neoplasms
NSCLC
Sweden
socioeconomic factors
educational level
aged
elderly
immigration
depressive disorder
dysthymic disorder
anxiety
suicide
survival
registries
Oncology
onkologi

Added entries (persons, corporate bodies, meetings, titles ...)

Bergström, Stefan,DocentUmeå universitet,Onkologi(Swepub:umu)stbe0123 (thesis advisor)
Bergqvist, Michael,Adjungerad professorUmeå universitet,Onkologi(Swepub:umu)mibe0079 (thesis advisor)
Lambe, Mats,ProfessorKarolinska Institutet, Department of Medical Epidemiology and Biostatistics (thesis advisor)
Henriksson, Roger,ProfessorUmeå universitet,Onkologi(Swepub:umu)rohe0003 (thesis advisor)
Grønberg, Bjørn Henning,ProfessorNorwegian University of Science and Technology, Department of Clinical and Molecular Medicine, Trondheim, Norge (opponent)
Umeå universitetOnkologi (creator_code:org_t)

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