Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Dec;6(3):77-86.
doi: 10.2217/lmt-2017-0013. Epub 2017 Dec 1.

How equitable is access to treatment for lung cancer patients? A population-based review of treatment practices in Ontario

William K Evans  1   1 , Jennifer Stiff  2   2 , Kelly J Woltman  3   3 , Yee C Ung  4   4 , Sue Su-Myat  5   5 , Phongsack Manivong  3   3 , Kyle Tsang  3   3 , Narges Nazen-Rad  3   3 , Aryn Gatto  5   5 , Ashley Tyrrell  5   5 , Rebecca Anas  2   2 , Gail Darling  5   5 , Carol Sawka  6   6
Affiliations

How equitable is access to treatment for lung cancer patients? A population-based review of treatment practices in Ontario

William K Evans et al. Lung Cancer Manag. 2017 Dec.

Abstract

Aim: Guideline concordance is one of the metrics used by the Cancer Quality Council of Ontario and Cancer Care Ontario to assess the quality of cancer care and to drive quality improvement.

Materials & methods: The rates for lung cancer surgical resection and concordance with the Cancer Care Ontario postoperative adjuvant chemotherapy (AC) guideline were assessed by health region during two time periods (2010-2011 and 2012-2013) according to five equity measures (age, sex, neighborhood income, location of residence and size of immigrant population).

Results: Of the patients with stage I/II NSCLC, 52.2% to 63.0% underwent surgical resection in the province of Ontario, Canada; for patients with stage IIIA disease, the rate was 26.4%. The probability of a surgical resection decreased substantially with age; only 26.9% of those with potentially resectable (stage I-IIIA) disease over 80 years underwent surgery. The use of postoperative AC increased modestly over the time of the study but the rate of use varied widely by health region (34.6 to 84.6%). Patients in rural areas were as likely to receive AC as urban dwellers; however, older aged patients (≥65 years) and those from the lowest income neighborhoods were significantly less likely to receive AC.

Conclusion: Surgical rates and the use of AC vary by health region in Ontario and by age and level of neighborhood income despite universal access in a publicly funded health care system. The reasons for this variance are unclear but warrant further study.Presented in part at the 15th World Conference on Lung Cancer, Sydney, Australia, 27-30 October 2013.

Keywords: access to treatment; equity; lung cancer.

PubMed Disclaimer

Conflict of interest statement

Financial & competing interests disclosure The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript.

Figures

<b>Figure 1.</b>
Figure 1.. Flow chart showing how the non-small-cell lung cancer cohorts were constructed.
ALR: Activity level reporting; DAD: Discharge abstract database; NACRS: National ambulatory care reporting system; PCCF: Postal code conversion file.
See this image and copyright information in PMC

References

    1. Cancer Care Ontario. www.cancercare.on.ca
    1. Program in Evidence-based Care. www.cancercare.on.ca/about/programs/pebc/
    1. Lung Cancer Evidence-based Series (EBS) and Practice Guidelines (PG) www.cancercare.on.ca/toolbox/qualityguidelines/diseasesite/lung-ebs/
    1. Anas R, Bell R, Brown A, Evans WK, Sawka C. Healthcare Quarterly; Toronto, Ontario: 2012. A ten-year history: the Cancer Quality Council of Ontario; pp. 24–27. 15 Spec No. - PubMed
    1. Cancer System Quality Index. www.csqi.on.ca/

LinkOut - more resources