Socio-economic status and patterns of care in lung cancer

Objective: This retrospective study aims to explore the associations between socioeconomic factors and lung cancer management and outcomes in the Australian setting. Methods: The study population consisted of patients who were living in the Northern Sydney Area Health Service (NSAHS) or South Western Sydney Area Health Service (SWSAHS) at the time of their lung cancer diagnosis in 1996. Data on patient demographics, tumour characteristics, management details, recurrence and survival were collected and compared between the two areas. Socio-economic status indicators of the two Area Health Services were obtained from the Australian Bureau of Statistics. Results: There were 270 and 256 new cases of lung cancer identified in NSAHS and SWSAHS respectively. Patients in NSAHS were slightly older and there were more women. Based on the 1996 Census data, the population of NSAHS is more affluent, better educated and more likely to be employed compared with SWSAHS. The stage distributions and performance status of the two areas were similar. The utilisation rates of different treatment modalities in the two areas were similar except for chemotherapy. The five-year overall survival rate was 10.5% in NSAHS and 7.2% in SWSAHS (p=0.08). Comparison based on the SEIFA Index of Relative Socio-economic Disadvantage did not reveal significant differences. Conclusion: Patients with lung cancer had similar patterns of care and survival despite differences in socio-economic profiles between the two Area Health Services. Implication: There seems to be equity of access to lung cancer services between the two Area Health Services.