title: Social deprivation does not affect lung cancer stage at presentation or disease outcome.
abstract: BACKGROUND
  Lung cancer mortality rates are higher in more deprived populations. This may simply reflect higher incidence of the disease, or additionally delayed presentation and worse outcomes amongst more deprived patients. Low socio-economic status (SES) has also been linked to cancer fatalism which might account for such differences. We determined the interaction between SES, patient's characteristics at presentation with lung cancer, and disease outcome at a large UK teaching hospital.
  
  
  METHODS
  Stage, PS at presentation, treatment and survival data, index of multiple deprivation score and ACORN group (geo-demographic segmentation tool) were analysed for 1432 patients.
  
  
  RESULTS
  There were no significant differences in stage or PS distribution by IMD quintile or ACORN group. When patients with stage I/II disease were considered, there were no differences in IMD or ACORN group for those undergoing or not undergoing surgical resection. Similarly when the whole cohort was considered, there were no differences in these parameters between those receiving and not receiving any anti-cancer therapy. There was a non-significant trend to lower IMD score (i.e. less deprivation) in the stage IIIb/IV patients receiving palliative chemotherapy compared to those not receiving chemotherapy. There was no significant difference in median survival or one-year survival according to IMD quintile or ACORN group.
  
  
  CONCLUSIONS
  In our patient cohort, deprivation does not appear to affect stage or performance status at presentation, nor survival from lung cancer. If cancer fatalism is more prevalent in deprived populations, this does not appear to lead to later diagnosis nor worse disease outcome.
authors.affiliation: Leeds Teaching Hospitals NHS Trust, United Kingdom. leanne.cheyne@nhs.net
authors.forename: L
authors.initials: L
authors.lastname: Cheyne
authors.forename: A
authors.initials: A
authors.lastname: Taylor
authors.forename: R
authors.initials: R
authors.lastname: Milton
authors.forename: J
authors.initials: J
authors.lastname: Fear
authors.forename: M E J
authors.initials: ME
authors.lastname: Callister
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012923:Social Class; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents
keywords: Cancer fatalism; Lung cancer; Metastatic disease; Patient characteristics; SES; Social deprivation