WCLC 2025 - Posters & ePosters-P3.01.10 Income, Tumour Stage, and Treatment in Patients With Non-Small Cell Lung Cancer: A Population-Based Study in the Netherlands

P3.01.10 Income, Tumour Stage, and Treatment in Patients With Non-Small Cell Lung Cancer: A Population-Based Study in the Netherlands

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This population-based study in the Netherlands analyzed the association between income, tumor stage at diagnosis, and treatment in 71,025 patients with non-small cell lung cancer (NSCLC) diagnosed between 2017 and 2022, using data from the Netherlands Cancer Registry. The study also considered the role of ECOG performance status (ECOG-PS), categorizing patients as PS0-1 (better functional status) or PS2 (worse status), to account for its mediating effect between income and cancer outcomes.<br /><br />Key findings include that patients with intermediate or higher income were more frequently diagnosed with stage IV tumors compared to lower-income patients. Among patients with better performance status (PS0-1) and stage II or III tumors, those with higher income were more likely to receive cancer treatments such as surgery, radiotherapy, chemotherapy, immunotherapy, or targeted therapy. Similarly, for stage IV disease, higher-income patients were more likely to receive systemic treatments, regardless of performance status.<br /><br />The study revealed significant disparities in the treatment of NSCLC patients according to income, despite the Netherlands having a universal healthcare system. These differences persisted even after adjusting for age, sex, tumor substage, PD-L1 status, and presence of actionable mutations. The findings highlight that income influences the likelihood of receiving advanced treatments like immunotherapy or targeted therapy.<br /><br />The authors emphasize the importance of person-centered care and shared decision-making to address these inequalities. They suggest that stratifying analyses by ECOG-PS can reduce bias and better identify true disparities. The results underscore that socio-economic factors continue to impact cancer treatment access and outcomes, even in equitable healthcare settings, pointing to a need for targeted efforts to ensure all NSCLC patients receive optimal care regardless of income.

Asset Subtitle

Anouk Eijkelboom

Meta Tag

Speaker Anouk Eijkelboom

Topic Risk Factors, Risk Reduction & Tobacco Control

Keywords

non-small cell lung cancer

NSCLC

income disparities

tumor stage

ECOG performance status

cancer treatment

immunotherapy

targeted therapy

Netherlands Cancer Registry

universal healthcare