Social Disparities in Survival from Lung Cancer in Europe

Abstract

In Europe, lung cancer was the third most commonly diagnosed cancer in 2018 for both sexes combined and the leading cause of cancer death. It is also the most frequent cancer and the leading cause of cancer death worldwide. Despite new biological insights and the considerable diagnostic and therapeutic efforts made recently, lung cancer remains a deadly disease with one of the world’s lowest survival probability of all cancers. Similar to what occurs in incidence and mortality, Europe shows important differences in lung cancer survival among a variety of social groups. These differences have been examined less extensively than those in other cancer sites. We have reviewed 47 studies on the relationship between the social environment and lung cancer survival in European countries. Social disparities in lung cancer survival appear remarkably general, with the more deprived patients showing consistently lower survival after a lung cancer diagnosis. However, the effect sizes are generally smaller and not as consistent as those seen in cancers of a better prognosis. It seems that the social gradient in lung cancer survival in Europe is in part mediated by stage of disease at diagnosis and access to optimal treatment and specialised care, but further research on other potential contributing factors should be addressed. The influence of the social environment on the risk of dying from cancer is a global phenomenon, but the explanations for the social differences and the mechanisms underlying the social gradient in lung cancer survival in Europe are not very well known. In light of the results, priority should be given to further research on all possible social contributors to the differences in survival and improving early cancer diagnosis and better access to treatment and healthcare centres.