がんの科学と治療

Interventions to Reduce Differences in Lung Cancer Survival

Abstract

Lars Schwettmann*

Lung cancer is the leading cause of cancer related death globally, accounting for approximately. Prognosis used to be generally very poor, with 5-year survival rates ranging between different countries. Numerous prognostic factors have been investigated which include tumorrelated but also patient-related factors, as well as smoking status and cancer treatment. For example, a later stage at diagnosis, male gender and current smoking at diagnosis have been shown to predict particularly poor prognosis in lung cancer patients. Social inequalities in lung cancer survival have been reported for countries with and without universal health care systems. Irrespective of the type of socioeconomic measurement, studies reported lower survival for lower socioeconomic groups. Stage at diagnosis, comorbidity, cancer therapy and smoking status has been found to at least partly explain the association between socioeconomic status and lung cancer survival. A study including lung cancer patients resident in Denmark reported smaller hazard ratio estimates when additionally adjusting for stage at diagnosis, first-line treatment and comorbidities.