Borg Morten, Løkke Anders, Henriksen Margrethe, Wen Sara Witting Christensen, Ibsen Rikke, Hilberg Ole
Department of Medicine, Lillebaelt Hospital Vejle, University Hospital of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark.
Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
Clin Transl Oncol. 2025 Jul 9. doi: 10.1007/s12094-025-03994-y.
Lung cancer remains the leading cause of cancer-related deaths globally, with low-dose computed tomography (LDCT) screening widely implemented in several countries. However, current screening eligibility, based largely on the National Lung Cancer Screening Trial and NELSON trial outcomes, does not account for socioeconomic risk factors such as education and employment status, which may impact lung cancer incidence and outcomes.
This study used data from the Danish National Patient Register to examine educational attainment and employment status among 109,940 lung cancer patients diagnosed between 1994 and 2018, compared to a randomly selected matched general population cohort.
Patients were less likely to hold higher education degrees and more likely to be on disability pension compared to controls, underscoring a significant socioeconomic disparity. Lung cancer patients frequently had only primary school education, with this educational gap widening over time. Employment disparities were also noted, with lung cancer patients twice as likely to be on disability benefits. These findings suggest that socioeconomic vulnerabilities, including educational level and employment, may exacerbate lung cancer risk, possibly linked to higher smoking prevalence and occupational carcinogen exposure in lower socioeconomic groups. Targeted public health initiatives focusing on smoking cessation and LDCT access for socioeconomically disadvantaged individuals are crucial for addressing these disparities and improving lung cancer outcomes. National wealth alone appears insufficient in bridging these socioeconomic gaps, emphasizing the need for strategic, targeted interventions in lung cancer prevention and early detection.
肺癌仍是全球癌症相关死亡的主要原因,低剂量计算机断层扫描(LDCT)筛查已在多个国家广泛实施。然而,目前的筛查资格主要基于国家肺癌筛查试验和NELSON试验的结果,并未考虑教育和就业状况等社会经济风险因素,而这些因素可能会影响肺癌的发病率和治疗结果。
本研究使用丹麦国家患者登记处的数据,对1994年至2018年间确诊的109940例肺癌患者的教育程度和就业状况进行了调查,并与随机选择的匹配的普通人群队列进行了比较。
与对照组相比,患者获得高等教育学位的可能性较小,领取残疾抚恤金的可能性较大,这突出了显著的社会经济差异。肺癌患者通常只有小学教育水平,而且这种教育差距随着时间的推移而扩大。还注意到就业差异,肺癌患者领取残疾福利的可能性是对照组的两倍。这些发现表明,包括教育水平和就业在内的社会经济脆弱性可能会加剧肺癌风险,这可能与社会经济地位较低群体中较高的吸烟率和职业致癌物暴露有关。针对社会经济弱势个体开展的以戒烟和提供LDCT筛查为重点的公共卫生倡议,对于解决这些差异和改善肺癌治疗结果至关重要。仅靠国家财富似乎不足以弥合这些社会经济差距,这凸显了在肺癌预防和早期检测方面采取战略、有针对性干预措施的必要性。