Abstract
IntroductionSocioeconomic disparities have been linked to survival differences in patients with lung cancer. Swedish healthcare is tax-funded and provides equal access to care, therefore, survival following lung cancer surgery should be unrelated to household income. The aim of this study was to investigate the association between household disposable income and survival following surgery for lung cancer in Sweden.MethodsWe conducted a nationwide population-based cohort study including all patients who underwent pulmonary resections for lung cancer in Sweden 2008–2017. Individual-level record linkages between national quality and health-data registers were performed to acquire information regarding socioeconomic status and medical history. Cox regression by quintiles of household disposable income was used to estimate the adjusted risk for all-cause mortality.ResultsWe included 5500 patients and the age-adjusted and sex-adjusted incidence rate of death per 100 person-years was 15 and 9.4 in the lowest and highest income quintile, respectively (mean follow-up time 3.2 years). Deprived patients were older, had more comorbidities and were less likely to have preoperative positron emission tomography or minimally invasive surgery, compared with patients with higher income. The adjusted HR for death was 0.77 (95% CI: 0.62 to 0.96) for the highest income quintile compared with the lowest.ConclusionsWe found an association between household disposable income and survival in patients who underwent surgery for lung cancer in Sweden, despite tax-funded universal health coverage. The association remained after adjustment for differences in baseline characteristics.
Funder
The regional ALF agreement between Stockholm County Council and Karolinska Institutet
Åke Wiberg Stiftelse
Karolinska Institutet Foundations and Funds
The Swedish Heart-Lung Foundation
Subject
Pulmonary and Respiratory Medicine
Reference41 articles.
1. Socioeconomic Inequalities in Lung Cancer Treatment: Systematic Review and Meta-Analysis
2. The Association Between Income and Life Expectancy in the United States, 2001-2014
3. Association of household income with life expectancy and cause-specific mortality in Norway, 2005-2015;Kinge;JAMA,2019
4. Statistics Sweden . Demographic report 2016:2. life expectancy and mortality in different social groups. Available: https://www.scb.se/hitta-statistik/statistik-efter-amne/befolkning/befolkningsframskrivningar/demografisk-analys/pong/publikationer/livslangd-och-dodlighet-i-olika-sociala-grupper/ [Accessed 12 Nov 2019].
5. Public Health Agency of Sweden . Public health development – annual report 2019, 2019. Available: https://www.folkhalsomyndigheten.se/publicerat-material/publikationsarkiv/f/folkhalsans-utveckling-arsrapport-2019/ [Accessed 12 Nov 2019].
Cited by
12 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献