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首页> 外文期刊>British Journal of Cancer >Geographical inequalities in lung cancer management and survival in South East England: evidence of variation in access to oncology services?
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Geographical inequalities in lung cancer management and survival in South East England: evidence of variation in access to oncology services?

机译：英格兰东南部地区肺癌管理和生存中的地域不平等：获得肿瘤学服务的差异的证据吗？

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This study aimed to determine whether the management and survival of patients with lung cancer varied among 26 health authorities in South East England. The Thames Cancer Registry identified patients diagnosed with lung cancer (ICD-10 codes C33–C34) between 1995 and 1999. After excluding death certificate only patients, 32?818 (81%) patients were analysed. The proportions of patients receiving active treatment varied among health authorities between 5 and 17% for non-investigative surgery, 4 and 17% for any chemotherapy, 8 and 30% for any radiotherapy and 15 and 42% for any active treatment. One-year patient survival ranged from 11 to 34%. There was evidence of health authority level variation even after adjusting for case mix. Patients whose first hospital attendance was at a radiotherapy centre were more likely to receive active treatment (OR 1.72, 95% CI 1.21–2.46), chemotherapy (1.38, 1.06–1.79) or radiotherapy (1.86, 1.28–2.71). There was some evidence that patients whose first hospital attendance was at a radiotherapy centre survived longer. This study shows there is geographical inequality in the treatment given to lung cancer patients and patient survival in South East England. There was some evidence to suggest that these inequalities might be explained by variations in access to oncology services. Future studies should investigate the pathways and barriers to specialist care in this condition.
机译：这项研究旨在确定在英格兰东南部的26个卫生机构中，肺癌患者的治疗和生存率是否存在差异。泰晤士河癌症登记处确定了1995年至1999年之间被诊断患有肺癌（ICD-10代码C33–C34）的患者。仅排除死亡证明后，对32？818（81％）患者进行了分析。在卫生当局中，接受主动治疗的患者比例在非调查性手术中介于5％和17％之间，对于任何化学疗法而言介于4％和17％之间，对于任何放射疗法而言分别为8％和30％，对于任何主动治疗而言，分别为15％和42％。一年患者生存率从11％到34％不等。即使根据病例组合进行了调整，也有卫生主管部门水平变化的证据。首次在放射治疗中心就诊的患者更有可能接受积极治疗（OR 1.72，95％CI 1.21-2.46），化学疗法（1.38，1.06-1.79）或放射疗法（1.86，1.28-2.71）。有证据表明，首次在放射治疗中心就诊的患者存活时间更长。这项研究表明，英格兰东南部的肺癌患者的治疗和患者的生存存在地区差异。有证据表明，这些不平等现象可能是由于获得肿瘤治疗服务的差异而引起的。未来的研究应调查这种情况下专科护理的途径和障碍。

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