RESUMO
BACKGROUND: In France, data on social environment influence on cancer management and prognosis are rare and no study has been conducted on lung cancer. This study was designed to investigate the associations between place of residence and occupation class, and diagnosis, treatment and prognosis of lung cancer. METHODS: The study population consisted of the 585 cases of lung cancer collected by the cancer registry of the Manche department (France) over a three-year period (1997-1999). Distribution of qualitative variables was tested using chi(2) test. Multivariate analysis were conducted using logistic regressions. Differences in actuarial survival were tested using log-rank test. RESULTS: Difference in diagnostic conditions did not demonstrate any prominence by social characteristics. People living in rural areas did however have a higher probability of therapeutic abstention than people living in urban areas (adjusted odds ratio=2.20 [1.18-4.10]). Similarly, people without any occupational activity had a probability of therapeutic abstention higher than people with an occupational activity (adjusted odds ratio=3.40 [1.99-5.80]). Moreover, occupational class and place of residence had a significant influence on the place of diagnosis and treatment, lower class and rural people being less often managed in university hospitals. Regarding prognosis, our results do not give prominence to difference in survival according to social characteristics. CONCLUSION: This study suggests that the type of center providing patient care and the nature of treatment given could be associated with the socioeconomic status of the patient. Nevertheless, due to the small sample size, further studies in a larger series would be required to make any formal conclusion.
