Title: Who are the vulnerable lung cancer patients at risk for not receiving first-line curative or palliative treatment?
Abstract: AbstractBackground To identify non-small-cell lung cancer (NSCLC) patients in need of comprehensive support, we examined the association between patient and disease-related factors of vulnerability related to not receiving guideline-recommended treatment.Material and methods We identified 14,597 non-small-cell lung cancer (NSCLC) patients with performance status <3 during 2013–2018 in the Danish Lung Cancer Registry. Multivariate logistic regression models were used to estimate Odds Ratios (ORs) and 95% confidence intervals (CIs) for receiving guideline-recommended treatment according to stage, comorbidities, age, performance status, long distance to hospital, cohabitation status, education and alcohol abuse.Results 21% of stage I-IIIA NSCLC patients did not receive curative treatment while 10% with stage IIIB-IV did not receive any oncological therapy. Factors associated with reduced likelihood of receiving curative treatment included: advanced stage (OR = 0.45; 95% CI = 0.42–0.49), somatic comorbidity (OR = 0.72; 95% CI = 0.63–0.83), age ≥ 80 years (OR = 0.59; 95% CI = 0.55–0.64), performance status = 2 (OR = 0.33; 95% CI = 0.28–0.39) and living alone (OR = 0.79; 95% CI = 0.69–0.90). Results were similar for stage IIIB-IV NSCLC patients, although a statistically significant association was also seen for long distances to the hospital (OR = 0.71; 95% CI = 0.58–0.86).Conclusions Several factors are associated with not receiving guideline-recommended NSCLC treatment with age, performance status, comorbidity and stage being most predictive of no treatment receipt. Efforts should be made to develop support for vulnerable lung cancer patients to improve adherence to optimal first-line therapy.Keywords: Non-small cell lung cancercurative treatmentpalliative treatmentvulnerability factors Authors' contributionsRikke Langballe, Erik Jakobsen, Maria Iachina, Susanne Oksbjerg Dalton and Pernille Envold Bidstrup contributed to the study conception and design. Data analysis was performed by Maria Iachina. The first draft of the manuscript was written by Rikke Langballe and Pernille Envold Bidstrup and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.Disclosure statementNo potential conflict of interest was reported by the authors.Data availability statementThe data that support the findings of this study are available from the corresponding author, upon reasonable request.Additional informationFundingThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.
Publication Year: 2023
Publication Date: 2023-09-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
Access and Citation
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot