title: Socioeconomic position, stage of lung cancer and time between referral and diagnosis in Denmark, 2001-2008.
abstract: BACKGROUND
  We investigated the association between socioeconomic position, stage at diagnosis, and length of period between referral and diagnosis in a nationwide cohort of lung cancer patients.
  
  
  METHODS
  Through the Danish Lung Cancer Register, we identified 18,103 persons diagnosed with lung cancer (small cell and non-small cell) in Denmark, 2001-2008, and obtained information on socioeconomic position and comorbidity from nationwide administrative registries. The odds ratio (OR) for a diagnosis of advanced-stage lung cancer (stages IIIB-IV) and for a diagnosis >28 days after referral were analysed by multivariate logistic regression models.
  
  
  RESULTS
  The adjusted OR for advanced-stage lung cancer was reduced among persons with higher education (OR, 0.92; 95% confidence interval (CI), 0.84-0.99), was increased in persons living alone (OR, 1.06; 95% CI, 1.01-1.13) and decreased stepwise with increasing comorbidity. Higher education was associated with a reduced OR for >28 days between referral and diagnosis as was high income in early-stage patients. Male gender, age and severe comorbidity were associated with increased ORs in advanced-stage patients.
  
  
  CONCLUSIONS
  Differences by socioeconomic position in stage at diagnosis and in the period between referral and diagnosis indicate that vulnerable patients presenting with lung cancer symptoms require special attention.
authors: Department of Psychosocial Cancer Research, Institute of Cancer Epidemiology, Danish Cancer Society, 49 Strandboulevarden, 2100 Copenhagen, Denmark. sanne@cancer.dk
authors: S O
authors: SO
authors: Dalton
authors: B L
authors: BL
authors: Frederiksen
authors: E
authors: E
authors: Jacobsen
authors: M
authors: M
authors: Steding-Jessen
authors: K
authors: K
authors: Østerlind
authors: J
authors: J
authors: Schüz
authors: M
authors: M
authors: Osler
authors: C
authors: C
authors: Johansen
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality / Q000523:psychology; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012017:Referral and Consultation; D012307:Risk Factors; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis / Q000401:mortality / Q000523:psychology; D012959:Socioeconomic Factors; D015996:Survival Rate; D013997:Time Factors