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@ARTICLE{Finke:153690,
author = {I. Finke$^*$ and G. Behrens$^*$ and L. Schwettmann and M.
Gerken and R. Pritzkuleit and B. Holleczek and H.
Brenner$^*$ and L. Jansen$^*$},
collaboration = {G. C. S. W. Group},
title = {{S}ocioeconomic differences and lung cancer survival in
{G}ermany: {I}nvestigation based on population-based
clinical cancer registration.},
journal = {Lung cancer},
volume = {142},
issn = {0169-5002},
address = {Amsterdam [u.a.]},
publisher = {Elsevier},
reportid = {DKFZ-2020-00394},
pages = {1 - 8},
year = {2020},
note = {Volume 142, April 2020, Pages 1-8#EA:C070#LA:C070#},
abstract = {Studies from several countries reported socioeconomic
inequalities in lung cancer survival. Hypothesized reasons
are differences in cancer care or tumor characteristics. We
investigated associations of small-area deprivation and lung
cancer survival in Germany and the possible impact of
differences in patient, tumor or treatment factors.Patients
registered with a primary tumor of the lung between
2000-2015 in three German population-based clinical cancer
registries were included. Area-based socioeconomic
deprivation on municipality level was measured with the
categorized German Index of Multiple Deprivation.
Association of deprivation with overall survival was
investigated with Cox regression models.Overall, 22,905
patients were included. Five-year overall survival from the
least to the most deprived quintile were $17.2\%,$ $15.9\%,$
$16.7\%,$ $15.7\%,$ and $14.4\%.$ After adjustment for
patient and tumor factors, the most deprived group had a
lower survival compared to the least deprived group (Hazard
Ratio (HR) 1.06, $95\%$ confidence interval (CI) 1.01-1.11).
Subgroup analyses revealed lower survival in the most
deprived compared to the least deprived quintile in patients
with stage I-III [HR: 1.14, $95\%$ CI: 1.06-1.22]. The
association persisted when restricting to patients receiving
surgery but was attenuated for subgroups receiving either
chemotherapy or radiotherapy.Our results indicate
differences in lung cancer survival according to area
deprivation in Germany, which were more pronounced in
patients with I-III stage cancer. Future research should
address in more detail the underlying reasons for the
observed inequalities and possible approaches to overcome
them.},
cin = {C070 / C120 / HD01},
ddc = {610},
cid = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
I:(DE-He78)HD01-20160331},
pnm = {313 - Cancer risk factors and prevention (POF3-313)},
pid = {G:(DE-HGF)POF3-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:32044589},
doi = {10.1016/j.lungcan.2020.01.021},
url = {https://inrepo02.dkfz.de/record/153690},
}