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Influence of timeliness and receipt of first treatment on geographic variation in non-small cell lung cancer mortality.
- Source :
-
International journal of cancer [Int J Cancer] 2021 Apr 15; Vol. 148 (8), pp. 1828-1838. Date of Electronic Publication: 2020 Oct 21. - Publication Year :
- 2021
-
Abstract
- Mortality from non-small cell lung cancer (NSCLC) exhibits substantial geographical disparities. However, there is little evidence on whether this variation could be attributed to patients' clinical characteristics and/or socioeconomic inequalities. This study evaluated the independent and relative contribution of the individual- and area-level risk factors on geographic variation in 2-year all-cause mortality among NSCLC patients. In the Hierarchical-related regression approach, we used the Bayesian spatial multilevel logistic regression model to combine individual- and area-level predictors with outcomes while accounting for geographically structured and unstructured correlation. Individual-level data included 3330 NSCLC cases reported to the Victoria Lung Cancer Registry between 2011 and 2016. Area-level data comprised socioeconomic disadvantage, remoteness and pollution data at the postal area level in Victoria, Australia. With the inclusion of significant individual- and area-level risk factors, timely (≤14 days) first definitive treatment (odds ratio [OR] = 0.73, 95% credible interval [Crl] = 0.56-0.94) and multidisciplinary meetings (MDM) (OR = 0.74, 95% Crl = 0.59-0.93) showed an independent association with a lower likelihood of NSCLC 2-year all-cause mortality. Timely and delayed (>14 days) first nondefinitive treatment, no treatment, advanced clinical stage, smoking, poor performance status, public hospital insurance and area-level deprivation were independently associated with a higher likelihood of 2- and 5-year all-cause mortality. NSCLC's 2-year all-cause mortality exhibited substantial geographic variation, mainly associated with timeliness and receipt of first definitive treatment, no treatment followed by patient prognostic factors with some contribution from area-level deprivation, MDM and public hospital insurance. This study highlights NSCLC patients should receive the first definitive treatment within the recommended 14-days from diagnosis.<br /> (© 2020 Union for International Cancer Control.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Bayes Theorem
Carcinoma, Non-Small-Cell Lung diagnosis
Carcinoma, Non-Small-Cell Lung therapy
Female
Geography
Humans
Logistic Models
Lung Neoplasms diagnosis
Lung Neoplasms therapy
Male
Middle Aged
Risk Factors
Survival Rate
Victoria
Algorithms
Carcinoma, Non-Small-Cell Lung mortality
Lung Neoplasms mortality
Models, Theoretical
Registries statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1097-0215
- Volume :
- 148
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- International journal of cancer
- Publication Type :
- Academic Journal
- Accession number :
- 33045098
- Full Text :
- https://doi.org/10.1002/ijc.33343