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- Title
Characterizing Regional Variability in Lung Cancer Outcomes across Ontario—A Population-Based Analysis.
- Authors
Mullin, Monica L.; Shellenberger, Jonas; Whitehead, Marlo; Brundage, Michael; Eisenhauer, Elizabeth A.; Lougheed, M. Diane; Parker, Christopher M.; Digby, Geneviève C.
- Abstract
Background: Lung cancer (LC) is the leading cause of cancer-related mortality. In Ontario, Canada, there are significant survival differences for patients with newly diagnosed LC across the 14 provincial regions. Methods: A population-based retrospective cohort study using ICES databases from 01/2007–12/2017 identified patients with newly diagnosed LC through the Ontario Cancer Registry and those with LC as the cause of death. Descriptive data included patient, disease, and system characteristics. The primary outcome was 5-year survival by region. Results: 178,202 patient records were identified; 101,263 met inclusion criteria. LC incidence varied by region (5.6–14.6/10,000), as did histologic subtype (adenocarcinoma: 27.3–46.1%). Five-year cancer-specific survival was impacted by age, rurality, pathologic subtype, stage at diagnosis, and income quintile. Timely care was inversely related to survival (fastest quintile: HR 3.22, p < 0.0001). Adjusted 5-year cancer-specific survival varied across regions (24.1%, HR 1.12; 34.0%, HR 0.89, p < 0.001). Conclusions: When adjusting for confounders, differences in survival by health region persisted, suggesting a complex interplay between patient, disease, and system factors. A single approach to improving patient care is likely to be ineffective across different systems. Quality improvement initiatives to improve patient outcomes require different approaches amongst health regions to address local disparities in care.
- Subjects
CANADA; LUNG cancer; POPULATION; MEDICAL protocols; HEALTH equity
- Publication
Current Oncology, 2022, Vol 29, Issue 12, p9640
- ISSN
1198-0052
- Publication type
Article
- DOI
10.3390/curroncol29120757