What are the sociodemographic characteristics of lung cancer patients travelling far to get surgery?

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Alexandre Quillet, Nasreddine Khadraoui, Nicolas Isambert, Thomas Systchenko, Nolwenn Le Stang, Gautier Defossez
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Abstract

Background: Lung cancer remains a global public health challenge, with late-stage diagnosis limiting treatment options. Surgery is recommended for early-stage disease (I-IIIA) and can only be performed in authorized centres. The aim of this study is to provide a spatial description of access to surgery for lung cancer patients and to identify the sociodemographic characteristics of patients who are furthest from home for their treatment.

Methods: A population-based study was conducted on patients diagnosed with non-small cell lung cancer (stages I-IIIA) between 2008 and 2020, identified from the Poitou-Charentes Cancer Registry (south-western France). The distance between the patient's home and the place of surgery was computed using geographic coordinates. A map of patient flows by department was produced. Logistic regression models were used to identify sociodemographic and tumour factors associated with distance to surgery (cut-off 100km). Sensitivity analyses were performed by varying the distance threshold (50, 150 and 200km).

Results: Twenty-two percent of patients travelled more than 100km for surgery. This proportion was higher in Charente and Charente-Maritime (45% and 31% respectively) than in Deux-Sèvres and Vienne (9% and 2% respectively). Female sex and middle socioeconomic status were associated with a greater distance travelled for surgery. Sex was the only variable that remained significant for all thresholds studied.

Conclusions: Sociodemographic factors including sex, place of residence and socioeconomic status are important determinants of distance travelled for lung cancer surgery. These findings allow better understanding of these patients' pathways taking into account regional specificities.

肺癌患者远行手术的社会人口学特征是什么?
背景:肺癌仍然是一个全球性的公共卫生挑战,晚期诊断限制了治疗选择。建议手术治疗早期疾病(I-IIIA),只能在授权的中心进行。本研究的目的是为肺癌患者提供手术的空间描述,并确定远离家乡接受治疗的患者的社会人口学特征。方法:对2008年至2020年间诊断为非小细胞肺癌(I-IIIA期)的患者进行了一项基于人群的研究,这些患者来自普瓦图-夏朗德癌症登记处(法国西南部)。使用地理坐标计算患者家与手术地点之间的距离。制作了一张按科室划分的病人流动图。使用逻辑回归模型确定与手术距离(截止100公里)相关的社会人口统计学和肿瘤因素。通过改变距离阈值(50、150和200公里)进行敏感性分析。结果:22%的患者手术路程超过100公里。夏朗特和夏朗特-滨海地区的这一比例分别为45%和31%,高于双savores和Vienne地区的9%和2%。女性性别和中等社会经济地位与手术距离较大有关。性别是所有研究阈值中唯一保持显著的变量。结论:性别、居住地、社会经济地位等社会人口学因素是肺癌手术出行距离的重要决定因素。这些发现有助于更好地了解这些患者的途径,同时考虑到区域特异性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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