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Influence of timeliness and receipt of first treatment on geographic variation in non‐small cell lung cancer mortality

International Journal of Cancer Oct 16, 2020

Wah W, Stirling RG, Ahern S, et al. - In patients suffering from non‐small cell lung cancer (NSCLC), researchers assessed independent as well as relative contributions of individual‐ and area‐level risk factors on geographic differences in 2‐year all‐cause mortality using the Bayesian spatial multi‐level logistic regression model. Timely (≤ 14 days) first definitive treatment and multi‐disciplinary meetings (MDM) had an independent relationship with reduced odds of NSCLC 2‐year all‐cause mortality after incorporating significant individual‐ and area‐level risk factors. Factors that displayed an independent link with a higher chance of 2‐year and 5‐year all‐cause mortality included timely and delayed (> 14 days) first non‐definitive treatment, no treatment, advanced clinical‐stage, smoking, poor performance status, public hospital insurance, and area‐level deprivation. Overall, 2‐year all‐cause mortality from NSCLC showed substantial geographic disparity, predominantly related to timeliness and receipt of first definitive treatment, no treatment, followed by patient prognostic factors, with some contribution from area‐level deprivation, MDM, as well as public hospital insurance. NSCLC patients should undergo the first definitive treatment within the advised 14 days from diagnosis.

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