Social and economic factors in the choice of lung cancer treatment: A population-based study in two rural states

E. R. Greenberg, Christopher Chute, J. A. Baron, D. H. Freeman, J. Yates, R. Korson

Research output: Contribution to journalArticle

Abstract

We reviewed 1808 hospital charts representing virtually all patients given a diagnosis of non-small-cell lung cancer in New Hampshire and Vermont between 1973 and 1976 and found that the treatment of patients varied according to their marital status, medical insurance coverage, and proximity to a cancer-treatment center. Patients were more likely to be treated with surgery if they were married (odds ratio, 1.67; 95 percent confidence interval, 1.08 to 2.57) or had private medical insurance (1.52; 1.03 to 2.26). Among patients who did not have surgery, those with private insurance were more likely to receive another form of anticancer therapy - either radiation or chemotherapy (1.57; 1.18 to 2.09). Residing farther from a cancer-treatment center was associated with a greater chance of having surgery. Patients 75 years of age and older were less likely to have surgery (0.16; 0.08 to 0.35) or any other tumor-directed therapy (0.32; 0.19 to 0.54). The relation between the type of treatment and a patient's characteristics was not based on apparent differences in tumor stage or functional status, although both these factors were also strongly predictive of the type of treatment. Despite the fact that privately insured and married patients were more aggressively treated, they did not survive longer after diagnosis. We conclude that for non-small-cell lung cancer, socio-economic as well as medical factors determine treatment.

Original languageEnglish (US)
Pages (from-to)612-617
Number of pages6
JournalNew England Journal of Medicine
Volume318
Issue number10
StatePublished - 1988
Externally publishedYes

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Lung Neoplasms
Economics
Population
Insurance
Non-Small Cell Lung Carcinoma
Therapeutics
Neoplasms
Insurance Coverage
Marital Status
Radiotherapy
Odds Ratio
Confidence Intervals
Drug Therapy

ASJC Scopus subject areas

  • Medicine(all)

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Social and economic factors in the choice of lung cancer treatment : A population-based study in two rural states. / Greenberg, E. R.; Chute, Christopher; Baron, J. A.; Freeman, D. H.; Yates, J.; Korson, R.

In: New England Journal of Medicine, Vol. 318, No. 10, 1988, p. 612-617.

Research output: Contribution to journalArticle

Greenberg, ER, Chute, C, Baron, JA, Freeman, DH, Yates, J & Korson, R 1988, 'Social and economic factors in the choice of lung cancer treatment: A population-based study in two rural states', New England Journal of Medicine, vol. 318, no. 10, pp. 612-617.
Greenberg, E. R. ; Chute, Christopher ; Baron, J. A. ; Freeman, D. H. ; Yates, J. ; Korson, R. / Social and economic factors in the choice of lung cancer treatment : A population-based study in two rural states. In: New England Journal of Medicine. 1988 ; Vol. 318, No. 10. pp. 612-617.
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